Chronic transplant rejection with diminished renal function and development of serious hypertension resistant to treatment occurred in a 36-year-old patient 3 years after kidney transplantation. Symptoms of vascular obstruction resulted in detection of advanced stenosis of the external iliac artery prior to branching of the transplant artery. Obstruction disappeared after percutaneous transluminal dilatation of the stenosis, renal function improved, and blood pressure returned to normal with reduced medication.