With at least 8 randomized controlled trials, Fecal microbiota transplantation (FMT) has emerged as an effective and safe therapy for multiple recurrent C. difficile infection (CDI) (> 3 episodes). The European Society of Clinical Microbiology and Infectious diseases (ESCMID) and the Infectious Diseases Society of America (IDSA) have both included FMT has an option for recurrent episodes in published guidelines. In terms of regulation of FMT is classified depending on the countries, either as a drug or as a biologic product. To date, there is no standardized clinical approach to perform FMT. Clinicians need to be aware of the different steps before performing FMT. First they should decide whether the indication is appropriate, then select the donor, and discuss the risks benefits balance. Practically then, FMT delivery modalities (upper or lower route) will be chosen. Finally, follow-up and adverse event will be monitored at short and long term.