In renal transplant recipients to predisposing factors, the incidence of incisional hernia is high. In this article we reviewed the incidence of incisional hernia underlying causes methods of management and the results of surgical repair with polypropylene mesh (PM). We analyzed the records of 750 recipients who underwent renal transplantation (RTX) between February 1989 and October 2003 in our centre. Recipients with clinical sign of hernia at incisional site of graft were included in this study. Predisposing factors such as old age, sex, weight (obesity) surgical and medicinal complications after RTX were also reviewed .In recipients who underwent surgical correction of incisional hernia with propylene mesh; we evaluated the out come of this procedure. A total of 16 incisional hernias developed in 750 recipients (1.75%). Incisional hernia was recognized 12-425 days after RTX (mean: 42 days). Predisposing factors for incisional hernia were clearly identified in 5 patients (35%). There were transplant surgical complications such as urinary fistula in 2, lymphocele in 2, and wound haematoma in 1 patient. Other significant predisposing factors were: obesity (over 75 kg) age more than fifty years old, diabetes, and female gender. For nine patients who had large hernia were repaired with PM. Significant subcutaneous seroma was occurred in two cases which were successfully treated with local aspiration for several times. The majority of incisional hernias develop 1-3 months after RTX. Surgical complications of RTX surgery such as urinary fistula, lymphocele and medical situation of recipients such as over weight, diabetes are the most important predisposing factors for incisional hernia. Repair of incisional hernia in RTX recipients with PM is safe and effective with no significant complication.