Living kidneys constitute, no doubt, the best source of organs for kidney transplantation. Based on international results, donor nephrectomy has been considered as a safe procedure. It is on this assumption that the universal use of living donors has been justified. We have, thus, allowed ourselves to use living donors since the very beginning of our transplantation program. We reviewed the short term (ST) and long term (LT) complications of our donor nephrectomies in 208 and 100 patients respectively. No mortality was reported. ST complications were on the whole trivial except for 1.4% of the patients who developed retroperitoneal hemorrhage severe enough to necessitate blood transfusions. One patient (0.5%) developed a small pneumothorax that resolved spontaneously. The LT complications were evaluated in 100 donors followed up from 4 to 18 years post-nephrectomy. Renal function as measured by Scr was well preserved. The 0.02. Only one patient developed_average yearly rise in Scr (mg%) was 0.015 (15 years later) chronic renal failure necessitating chronic hemodialysis. Nineteen patients (18.8%) developed hypertension, defined as a BP higher than 140/90 mmHg. The average rise in mean BP since the time of the study was 13.42 16.96 mmHg. Twenty three per cent (23%) of the patients developed microalbuminuria. A thorough review of our single center experience with living donor nephrectomy over the last 18 years shows a low incidence of ST and LT complications. This is in line with the internationally published data. It allows us to continue with our judicious use of living donors as a source for kidney transplantation.