We present a case of kidney transplantation utilizing a fused kidney with inferior ectopia. The kidney had three arteries, five veins and two ureters and was procured en bloc with the donor vena cava and aorta. The caudal end of the donor vena cava was anastomosed to the recipient's external iliac vein. The right common iliac artery of the donor, in continuity with the donor aorta, was anastomosed to the recipient's external iliac artery. The two ureters were implanted separately. The patientwas discharged home with a serum creatinine of 0.9 mg/dl. Through innovative techniques, kidneys that may not have been transplantable in the past can now be used with excellent results. This is the first known report of transplantation using a unilateral fused kidney with inferior ectopia.