Renal graft survival depends on many factors. Renal transplant recipients are prone to accelerated atherosclerosis secondary to immunsupressive protocols and this process may also be a factor that play role in decreased graft survival. In this study we aimed to analyze effects of atherosclerotic degeneration at renal artery, on renal graft survival and influence of ACE-ecNOS gene polymorphisms on this process. 33 renal transplant recipients (25 men, 8 women; aged, 28.4 ± 9.6 years, 11 living related donors) who were been followed for at least 36 months after renal transplantation, were included in the study. Genotyping was performed in recipients for the insertion/deletion ACE (I/D), AGT (M_T, 235), ATR1 (A_C, 1166), ATR2 (A_G, 1223), and ecNOS (b_a, intron4) gene polymorphisms. Renal artery biopsies were performed during transplantation surgery for each case and specimens were analyzed for presence of atherosclerosis. Pathological examination indicated that 18 donor and 9 recipient renal artery specimens had atherosclerotic degeneration. Survival analysis of 36 months indicated that graft survival rates of recipients who had atherosclerosis at renal artery before transplantation and who recieved organ from donors with atherosclerotic renal artery were shorter than their counterparts (p=0.02, =0.04 respectively). Comparison of genetic variations of recipients revealed that atherosclerotic patients had higher percentage of CC/TC variation of AGT polymorphism (81% vs 53%, p=0.03) than non-atherosclerotic ones. There was no significant difference between groups in means of ACE, ATR1, ATR2, ecNOS gene polymorphisms. Renin-angiotensin system gene polymorphism analysis of patients in renal transplantation waiting list may provide information about allograft survival and posttransplant atherosclerotic degeneration at graft vasculature of young transplant recipients.