1000 kidney transplants had been performed in the kidney center, Jeddah between 1991 – 2004. Another 1000 patients had their transplant done outside Saudi Arabia in Pakistan and Egypt and are followed up in our center. We present 16 cases of major urological complications who were managed in our center; 4 cases of urine leak, 3 cases with lymphocele and 9 cases of ureteric obstruction, 5 at the uretero-vesical junction and 2 mid-ureteric. The presentation, radiological and endoscopic pre-operative assessment and surgical procedure for each group will be presented as well as their post-operative follow up. The graft and patient survival in this group of patients was 100 %. Team management by Radiologist, Urologist, Transplant Surgeon is necessary for appropriate management of theses urological problems.