The aim of this study is to evaluate donor and graft outcome in kidney transplantations from laparoscopic donor nephrectomies (LDN). From June 2000 to June 2004, 341 LDNs have been performed. Demographics and hospital records of these cases were reviewed. Mean age of donors and recipients were 27.59±4.80 (20 to 56) and 35.36±14.85 (3 to 75) years. Nephrectomy was left sided in 96.2%. Mean follow-up was 13.32±35.98 months. Mean warm ischemic time (WIT) was 8.17 (range 2.5 to 19) minutes. Mean operative time was 260.34 minutes. Median serum creatinine levels (Cr) of recipients (mg/dl) were 1.30, 1.45, and 1.20 at day 7, and months 1 and 12, respectively. One-year graft survival was 92.7%, 94.6%, and 92.6% in LDN groups with WITs of <6, 6 to 10, and >10 minutes, respectively (p=NS). Conversion to open surgery occurred in 2.1% of donors and reoperation was performed in 3.8% of LDNs. Blood transfusion was required in 7.1% of donors. Urerteral complications were observed in 2.1% of recipients. Vascular control was performed using medium large clips instead of endoGIA and kidney was extracted via a suprapubic approach using hand instead of endobag. Hence, 450$ was saved in each nephhrectomy. No vascular accident occurred from pedicular vessels. In conclusion: 1- LDN can be performed in a less expensive set up to be expanded in developing countries without jeopardizing the results. Since warm ischemic time in our study did not affect graft outcome significantly, it seems that there is no need to rush in harvesting the kidney to achieve a better quality kidney. 2- Vascular control using non-automatic clips instead of more costly endo GIA and hand extraction of kidney is safe, practical and economical.