In this paper, I argue that capability approach suggests a theoretical foundation to activate organ donation ethically and efficiently. People who have been forced to die due to the damage of organs, have been theoretically able to prolong their life through organ transplantation due to the development of modern science and technology, but in reality, many people are dying without organ transplants. This is because, in the current situation where the supply of organs for organ transplantation depends only on organ donation, the number of organ donors is significantly smaller than that of transplant recipients. In order to resolve this imbalance, financial incentive and ethical incentive strategies have been proposed but they are not only ethically unjustified, but also effectively infeasible. This is because, financial incentive is against the fundamental spirits of organ donation such as volunteerism and altruism, it leads to injustices to exploit the poor, and its effects are doubtful in history. Although ethical incentive strategies offer many non-financial incentive strategies in order to complement the weaknesses of financial incentive, their effects are doubtful because they do not propose a theoretical discussion on how non-financial strategies work with financial strategies. However, capability approach is effective in activating organ donation for three reasons. First, capability approach, which highlights the importance of health, is relevant to be a foundational discussion to justify the ethical legitimacy of organ transplantation and donation. Second, capability approach, which is a framework, rather than a theory, is appropriate to propose a systematic framework to cover not only theoretical discussions but also practical discussions to activate organ donation. Third, capability approach is effective to overcome limitations of established prior incentive strategies, through the systematical strategy of institutional, non-institutional, and individual aspects in order to promote capability. I hope that this theoretical work will effectively guide the practical work to activate organ donation sustainably.