In this study we report 3 cases with extensive Ureteral stricture that had been managed with Pyelo-Pyelostomy. From 620 renal transplantation that were performed in our center between (1982-2002), 3 recipients (2 Adult and 1 Child) 3, 4.5, 5 months after RTX were managed due to significant hydronephrosis and rising SUN-Cratinine. At first, percutaneous nephrostomy were performed and then nephrostography showed extensive ureteral stricture. One recipient had history of nephroureterectomy of native kidney of ipsilateral of graft and in two adult recipients due to severe adhesion of the ipsilateral native renal pelvis, ureter and bladder using of them were impossible, thus we performed in 3 recipients pyelo-pyelostomy with using contralateral renal pelvis after discarding small native kidney. Double J stent remained for 6 weeks. Long-term excretory function was achieved in all 3 recipients after pyelo-pyelostomy and there was not any obstruction. The median follow up was 30 months (range-6-4 months) median serum creatinine was 1.2 mg/dl(range 0.9-2 mg/dl) Pyelo-Pyelostomy with using contralateral renal pelvis appears to be a promising rescue technique .there is worth consideration when large part of the donor ureter has extensive stricture and ipsilateral native renal pelvis ,ureter or the flap of bladder can not to be used.