Acute myocardial infarction occurred in 11 of 212 consecutive renal transplant recipients. This incidence is more than 10 times greater than that for an age- and sex-matched unselected population. All 11 patients died from infarction. 5 of the first attack and the rest within the nest 12 months from recurrence. The risk of developing myocardial infarction was greatest for older recipients who had been suffering from angina pectoris prior to the transplantation.