Objective: To study uterine transplantation (UTx) being introduced in the UK in real-time, from the perspectives of key stakeholders: eligible women with absolute uterine factor infertility and the multidisciplinary team supporting them and performing the procedure. Design: A qualitative study utilising prospective case study methodology (in-depth, semi‐structured interviews and non‐participant observation) over six years. Setting: Two NHS trusts in England. To date, five UK transplants have been performed; two living donor transplants, and three deceased donor transplants. Three retrievals have also been undertaken that did not proceed to implantation. Methods and sample: Data included 17 audio-recorded consultations with potential recipients and clinicians, 22 interviews with seven clinicians, and eight follow-up interviews with women. Data were synthesised using thematic analytical methods. Results: Women described UTx as a deeply personal and identity-affirming pursuit, shaped by cultural/religious contexts. Clinicians navigated evolving perceptions of risk and the emotional intensity of participating in a pioneering programme—driven by long-term investment, empathy, and the significance of performing the UK’s first uterine transplants. Collaboration was crucial, involving learning from international teams, close multidisciplinary teamwork, and strong relationships between clinicians and recipients. Embedding prospective qualitative research enabled clinicians to reflect on their practice and provided insights into optimising UTx delivery. Findings offer practical examples for discussing uncertainty and risk, and improving support for women undergoing novel procedures. Conclusion: This study provides in-depth insights into the technical, emotional, and ethical complexities of introducing UTx. It highlights the value of dynamic qualitative methods within translational pathways for surgical innovation.