Use of marijuana and the varied forms of cannabis is steadily on the rise in the US as more states move to legalize the substance for both medicinal and recreational purposes. Transplant programs across the country also have a varied approach regarding pre and post-transplant use, as clear guidelines are lacking. Research into the effects of THC has been limited by its illegality at the federal level. Drug interactions warrant further evaluation and study. This review offers insight into the pre and post-transplant approach to marijuana and CBD oil use, drug interactions, and a review of proposed potential guidelines.