The search for calcineurin inhibitor free immunosuppressive protocols has been increased for the kidney transplant recipients for their side effect profile in the long term. In this study, at our center the clinical data of the patients who are taking sirolimus (SRL) alone and SRL+cyclosporine (CsA) were compared. Sirolimus including primary immunosuppressive treatment protocols have been used at the Akdeniz University Organ Transplantation Center since February 12 2002. Fourteen patients (9 male, 5 female) were included in this study. While 6 patients received prednisolone+SRL (group I), 8 patients received prednisolone +SRL+CsA (group II). Both groups were similar in terms of age and posttransplant follow-up period (In group I and group II age and posttransplant follow-up periods were as follows respectively: 28.6±4.6 years and 32.3±5.5 years; 14±1.5 months and 11±4.9 months. In both groups target trough levels for SRL were between 8-15 ng/ml. In group II CsA levels were assessed by C0 values and while in the first 3 months target trough levels were between 150-300 ng/ml, starting from the 4th month doses were reduced by 25% weekly targeting trough levels 50- 100 ng/ml. None of the patients experienced acute rejection and had hematologic complications. One of the patients in group I and 5 patients in group 2 developed lymphoceles. There was no significant statistical difference by the end of one year, in terms of creatinine levels between two groups (creatinine levels were as follows respectively in group I and group II: 1.4±0.1 and 1.5±0.8 mg/dl). In both groups there was a severe increase in the total cholesterol and triglyceride levels starting from 1st month posttransplant (total cholesterol levels pretransplant and at 1 month respectively: in group I 174.1±32.6 and 285.6±31.5 mg/dl, in group II 137.8±14.1 and 247.3±59.6 mg/dl; triglyceride levels pretransplant and at 1 month respectively: in group I 148.1±12.4 and 202.8±22.1 mg/dl, in group II 179.2±46.1 and 248.5±50.3) and those high levels were maintained for one year. It is very promising that at the end of the 1st year, serum creatinine levels of the patients using only SRL regimens remained under 1.5 mg/dl. SRL can be a suitable alternative agent in patients who cannot tolerate calcineurin inhibitors because of their side effects.