Cardiovascular morbidity and mortality among dialysis patients are sustantially higher than in the general population. It accounts for almost half of all deaths among this group of patients even at much younger age mostly secondary to cardiovascular calcification. The aim of this prospective study was to assess the extent of cardiovascular calcification among dialysis patient and to assess the possible reversibility after successful kidney transplantation. A total of 57 patients (77% males) who received a live-donor renal allografts between November 2002 and May 2003 were enrolled in this study. Serum calcium, phosphorus, alkaline phosphatase, cholesterol and parathormone were estimated at base line then at 3, 6, 12, and 18 months posttransplant. Also, the doses of vitamin D and Calcium were considered. Likewise, at the same time points, coronary artery calcification (CAC) was assessed by one observer via measurement of coronary calcium score and volume using the multidetector spiral CT at 130 Hu thresholds. Baseline CT scan showed significant CAC in 13 patients (22.8%). The significant risk factors for development of CAC among our patients were older age (Median: 48 vs 24 years, p = 0.0002), longer duration of dialysis (Median = 30 vs 7 month, P = 0.0001). Among the 13 patients with evident CAS, 8 recipients completed their follow up CT scans and 5 recipients showed complete disappearance of calcification (62.5%), two showed stabilization (25%),while one patientshowed inceased score and volume of calcification. On the other hand, among the remaining 44 patients with no CAC at baseline, 18 recipients completed their follow up scans at 18 months post transplant and all remained calcification free. In conclusion, these preliminary results showed that successful renal transplantation improve, slow down or stabilize CAC. However, longer follow up period and larger numbers of patients are needed to confirm the positive impact of kidney transplantation on cardiovascular calcification.