Kidney transplantation is the therapy of choice in children with ESRD. Current success in pediatric renal transplantation is attributed to improvements in immunosuppressive therapy, histo-compatibility matching and the provision of age appropriate clinical care. Mycophenolate mofetil (MMF) is widely used to prevent acute rejection in adults after renal, cardiac, and liver transplantation. Preliminary data demonstrate improved longitudinal growth, less cushingoid habitus and lower blood pressure after steroid-withdrawal in pediatric renal transplant recipients under MMF and Cyclosporine therapy. Thus we decided to investigate the effects of MMF in pediatric renal transplantation in Labafi Nejad Hospital. In this study we assessed 216 patients who received renal transplants between 1985 and 2004. One hundred patients received mycophenolate with cyclosporine and prednisolone (group A), and 116 patients received cyclosporine and prednisolone (group B). Chronic rejection was seen in 37% of patients in group A and in 29% of patients in group B. Thus the relationship between MMF consumption and chronic rejection was not meaningful (Pv =0.27). In this study, graft failure was seen in 10% of patients in group A and 52% of patients in group B and this difference was meaningful (Pv =0.00). The rate of graft survival in the first year after transplantation was 100%, rates for third, fifth and seventh years after transplantation were 93%, 90% and 82% respectively in group A. In contrast, graft survival rate was 78% at 1 year, 61% at 3 years, 56% at 5 years and 35% at 7 years after renal transplantation in group B. Mean graft survival time was 9.8 years in patients received MMF (group A) and 5.8 years in patients of group B. Thus we concluded that the relationship between mycophenolate and graft survival is meaningful (Pv = 0.00). Also we concluded that mycophenolate in immunosuppresive protocols of our patients (Group A) increased graft survival in patients with chronic rejection (Pv =0.003).