The objective of the study was to determine whether using a living donor kidney with arteriographic evidence of renovascular disease affects the outcome of the recipient's transplanted graft. Twenty-eight patients who had unilateral renovascular abnormalities on conventional angiography underwent donor nephrectomy of the ipsilateral kidney. Results in the recipients who received these kidneys were reviewed. Comparison was made to a control group of living donor renal transplant recipients who were matched for donor, recipient age. Graft survival, patient survival, serum creatinine for all 28 recipients were evaluated. All 28 donors underwent a successful donor nephrectomy. Recipient graft survival was 96% at 1 yr, 92% at 3 yr, 71% at 5 yr, 62% at 10 yr. Mean serum creatinine values at 1 month, 1 yr, 3 yr were 1.5, 1.5, 1.6, respectively. Similar results were observed in the control group. We conclude that renal transplantation utilizing kidneys with arteriographic evidence of renovascular disease results in excellent short, long-term renal allograft survival.