Nephrectomy for native kidney is the most common adjuvant operation in renal transplantation. Transplantation is traditionally done 6 to 12 weeks after nephrectomy. We retrospectively evaluated patients with ADPKD who underwent simultaneous nephrectomy with renal transplantation. Between January 1987 and end of 2003, 13 patients with ADPKD underwent bilateral and right native nephrectomy due to creating room for concomitant renal grafting We examined intra operative and postoperative parameters including operative time, intra operative transfusion requirement, time to oral intake, hospital stay, post operation deep vein thrombosis (DVT), wound dehiscence and infection, last serum creatinine level, incisional hernia and second administration rate. The mean patients’ age was 37.7 years included 9 male and 4 female. Intra operative blood transfusion was done for 5 patients at rate of 1 unit. Average operation time for 13 procedures was 185 minutes ± 39.4. The time to resumption of oral intake was the first day of post operation at all patients. Average length of hospitalization was 16.6 days ± 7.6. The patients were discharged with mean serum creatinine level 1.2mg/dl ± 0.44. Native nephrectomy concomitant with grafting for enlarged polycystic kidney is favourable and feasible.