Renal allograft vein thrombosis (RVT) is an uncommon but serious complication of renal transplantation. It usually occurs early after transplantation surgery, as a result of compression of renal graft vein, or secondary to early severe rejection and haemostatic defects. It usually presents with haematuria, and sudden drop of urine output and rise of serum creatinine. Diagnosis is often delayed because of the non specific clinical features. Findings on ultrasound Doppler (USD) and isotope scanning may resemble those of acute rejection or acute tubular necrosis.The medical records of 684 recipients transplanted between Nov. 1993 and June 2006 were retrospectively reviewed. 399 of recipients were males, and 191 received cadaveric kidney grafts. 86 recipients were children. Diagnosis of RVT was suspected by the clinical picture and the findings on USD and isotope scan. Urgent exploration was performed in all suspected cases. Seven incidents of biopsy-proven RVT were recorded at 1-8 days after transplantation; it was associated with perigraft haematoma in 3, and acute vascular rejection in one case. 3 of recipients were males, and one recipient was a child. 4 of thrombosed grafts were from cadaveric donors. Three renal grafts were salvaged by early renal vein thrombectomy, two out of these are dialysis free for 6 months and 4 years, and third graft was lost secondary to chronic dysfunction 6 months later. The incidence of RVT in the present series is 1%. It develops during the first post-transplantation week, and tends to be more common with cadaveric transplantation (2%). Renal grafts could be salvaged if RVT is diagnosed and treated early.