Renal allograft transplantation with multiple arteries (MA) was always less preferred and it was avoided as much as possible as it is technically demanding and carries higher complication risk. To determine patient and graft outcome of live and cadaveric kidney transplantation with multiple renal arteries. We reviewed total number of 646 cases which were transplanted between November 1993 and December 2005, 185 (28%) from cadaveric donors (CAD), (72%) live donors. Thirty-five allografts with MA, 18 CAD, 9 LRD, 8 LURD. We analyzed surgical techniques, number and type of anastomosis, serum creatinine, arterial thrombosis and stenosis, hypertension, graft and patient survival. ut of 35 grafts, 30 had duple arteries, 21 of them transplanted with 2 separate end to side anastomosis to external iliac arteries, 9 had single (conjoined or cuff anastomosis). Five grafts had 3 arteries, with duple or multiple anastomosis, and all were end to side to external iliac artery. Two patients developed perigraft hematoma 5.7%, compared to 4.5% in the single artery (SA) group. Serum creatinine of MA group at one month recorded (122.3+44.5) (MEAN+SD), (139+86) at one-year and (156+151.5) at 5 years. One case showed renal artery stenosis presented with resistant hypertension. Six grafts 17% were lost in MA group, in 10 years, compared to 15.6% in SA group. We had 5 patients lost in 10 years in MA group 14%. Three in cadaveric group 16%, one with pulmonary embolism, two with septicemia, compared to 12% in SA group, and one in each of LRD and LURD groups. Although MA renal allografts might carry a higher relative risk for complications, but it gives comparable results in graft and patient outcomes to SA grafts, which justifies its use.