The aim is to evaluate the impact of the routine use of Double-J stents in live-donor renal transplantation at a single institute based on a prospective randomized study. Between January 2002 and March 2003, 118 consecutive cases of live-donor renal transplantation were carried out at our institute. Eighteen patients were excluded from the study because of young age (<10 years), uretero-ureteral anastomosis, abnormal lower urinary tract ad intra-operative technical difficulties. The remaining patients were prospectively randomized into two groups, 50 patients each. Group I received routine double J Silicone ureteric stent while group II were non-stented. A standard Lich-Gregoir ureteroneocystostomy was carried out in both groups. In group I, the patients were scheduled to remove the stents after two weeks. Both groups were comparable in relation to age, sex, bilharzial affection, ischemia time, number of renal arteries and time to diuresis. In group I, two grafts were lost early post-operative and were excluded from final analysis. None of our patients in either group developed ureteric strictures with mean follow up period of 10.8+3.6 months. In the stented group, two patients developed urinary leak whereas no leakage was reported in the non-stented group (P=0.14). While nineteen patients in group I (39.6%) had urinary tract infection, only 9 in group II (18%) showed evidence of positive urine culture (P=0.02). The presence of ureteric stents as well as female gender was the independent predictors of post-operative urinary tract infection on multivariate analysis. There was no statistically significant difference between both groups regarding post-operative hematuria or wound complications (P=0.29 & 0.81 respectively). The mean serum creatinine levels at discharge were 1.2+0.3 and 1.2+0.4 mg % in both groups respectively (P=0.2). In conclusion, routine ureteral stent insertion has no impact on the rate of vesicoureteral leakage and obstruction in live-donor renal transplantation while it is significantly associated with increased incidence of urinary tract infection.