North African Countries include Algeria, Egypt, Libya, Morocco and Tunisia. A comprehensive overview on the current status of organ and tissue transplantation activities in North African Countries is provided. A special emphasis will be laid upon renal and hepatic transplantation. Regarding renal transplantation, the five countries depend mainly on living donors as a source of organs, where Egypt is leading transplanting about 3000 cases in the period of 1993 to 2002. Most cases come from living donors since the law does not permit cadaveric transplantation in Algeria, Egypt and Libya. The outcome regarding graft and patient survival conforms with international standards although infections remain a major cause for morbidity and mortality. Data regarding liver transplantation are less available. This review will try as much as possible to record this activity.