Chronic hepatitis B increases the risk of morbidity and mortality after kidney transplantation. The aim of this prospective study is to evaluate the efficacy and safety of Lamivudine therapy in treatment of chronic hepatitis B among Egyptian live-donor kidney transplant. Ten recipients were enrolled in this study, 9 males and 1 female with mean age 34.4 ± 7.1 years. Immunosuppressive regimens were; tacrolimus-based in 5, cyclosporine-based in 4 and Sirolimus-based in the remaining one. All the patients had normal liver enzymes with positive HBsAg, HBeAg and HBV DNA. All the patients were subjected to histological evaluation and showed different degrees of chronic hepatitis with no evidence of cirrhosis. Lamivudine which is increasingly used for treatment of chronic hepatitis B, was administrated to our recipients at 100mg single daily dose to be adjusted according to the renal function. The mean serum creatinine at start of Lamivudine was 1.54± 0.28 mg/dL and the mean duration of therapy was 18.3 ± 3.7 months. HBV DNA significantly decreased in all patients and was undetectable in 4 patients at 6 months. The median HBV DNA prior to Lamivudine therapy was 47,310,000 copies/ml and significantly dropped to 19.600 after 6 months, 6400 by the end of the first year then only 146 copies/ml after 18 months. In addition, HBeAg clearance was achieved in 4 recipients at 6 months with development of HBeAb. Moreover, one patient was negative for HBsAg after 18 months of therapy. Lamivudine therapy did not affect either the graft function or the dose of immunosuppressive drugs. In conclusion, Lamivudine is a safe, well tolerated drug in management of live-donor renal allograft recipients with hepatitis B. However, further studies are needed to address the proper duration of treatment.