Objective To summarize recent clinical advances in intra-abdominal vascularized lymph node transfer (VLNT) for treatment of limb lymphedema. Methods A comprehensive review of the literature on intra-abdominal VLNT was conducted, outlining its historical development, relevant anatomy, and clinical applications, with emphasis on clinical outcomes. Results Intra-abdominal donor sites, such as the omentum and mesentery, are rich in lymphoid tissue and exhibit favorable anti-infective properties. Intra-abdominal VLNT has been widely applied in clinical practice internationally, while reports from China remain limited. Clinical studies indicate that the intra-abdominal VLNT can effectively reduce limb swelling, lower incidence of infection, and improve quality of life in patients with limb lymphedema. It can also be combined with lymphaticovenular anastomosis, reductive procedures, and breast reconstruction to further alleviate symptoms and enhance patient-reported outcomes. Conclusion Intra-abdominal VLNT holds clinical application potential for the treatment of limb lymphedema, but more rigorous, standardized clinical studies are needed to further verify its feasibility and efficacy.