Transplantation provides a suitable option for patients suffering from end stage organ failure. Immunosuppressive field is fludded with many agents leading to a dilemma with difficulty to choose appropriate combination of maintenance therapy, treat episodes of acute rejection with varying severity and tailor therapies for specific patients (s). Induction therapy strategies can be adopted either by relative higher doses of conventional immunosuppressants or utilizing anti T cell antibodies. The rationale for the antibodies therapy aimed to augment immunosuppression, ensure safety of delayed introduction of calcineurin inhibitor, encourage steroid withdrawal, facilitates treatment of sensitized patients beside its crucial role in immunological conditioning either by tolerance induction or minimizing immunosuppressive drugs. Different trends of induction therapy are at the hand starting initially by polyclonal antibodies, subsequently by monoclonal antibodies and finally by anti CD 20, 25, 52 agents. So induction therapy is associated with beneficial short and long term outcome with concerns of increased risks of side effects related to suppression of immune system especially CMV and lymphomas.