Cyclosporine (CsA) microemulsion blood levels at 2 hours (C2) have been shown to be useful to evaluate area under the curve (AUC) and to undertake done adjustments. This study reports outcome of live related renal transplant recipients monitored by C2 levels and their pharmacokinetic profiles. One hundred patients received live related renal transplants between April 2002 to October 2003. All received Neoral at 8 mg/kg/day and Azathioprine 1.5 mg/kg. A sparse sampling AUC was undertaken on day 5 at 0, 2, 3 6, and 12 hours. An AUC of 6000–8500 ng/ml/hr was taken as adequate. Initial dose adjustment were by AUC, thereafter all monitoring was done by C2 levels. Adequate C2 1000 – 1500 ng/ml at 3 months, 800 – 1300 at 6 months and 700 – 1000 at 12 months. C2 levels were done at 1, 3, 6 and 12 months or when indicated. Graft functions was evaluated at 3, 6 and 12 months. All dysfunction were confirmed by biopsy, color Doppler and CsA levels. End point was outcome at 6 and 12 months. CsA was estimated by Abbott TDX. The mean age of recipients was 31.5±9.2 with M:F ratio of 3:1 with a mean follow up of 425±187 days. The mean AUC was 7529±1926, C0 304±114 and C2 1394±348 at day 5. AUC was adequate in 59, high in 17 and low in 24. Correlation of C0 vs AUC was 0.75 (p=0.0001) and C2 vs AUC 0.72 (p=0.0001). Mean dose was 7.4±1.0, Mean C2 level and dose at 1 month was 1147±278 and 5.5±1.4 3, 3 months 1131±339 and 4.9±1.4, 6 months 1016±283 and 4.2±1.2 and 12 months 924±115 and 3.9±1.1. Of the 100 patients 12 experienced rejection and 18 had toxicity within the first three months. Mean creatinine (mg/dl) at 3 months was 1.28±0.33, 6 months 1.18±0.53 and 12 months 1.06±0.6. In the follow up period two patients died of sepsis and two grafts were lost due to chronic rejection. Initial AUC necessitated dose adjustment in 40% of the cases while C2 levels necessitated dose adjustment in 20–35% of cases at 3, 6 and 12 months. During the first 6 months repeat AUC was done in 14 patients. In conclusion C2 is a valuable marker of overall AUC in 75–80% of the patients and a better monitoring tool.