An active programme to expand the donor pool by procuring cadaveric organs was started in March 1996. The aim of this paper is to investigate the outcome of cadaveric kidney transplantation performed in a single centre in a developing country. The medical records of 191 patients who received cadaveric kidney grafts were retrospectively reviewed. Eighty-three recipients were males, and 36 were children under the age of 18 years. Many patients had, beside renal failure, one or more other high risk factors. Renal grafts were transplanted after a short ischaemia (mean 12.5 hours), and the procedure was a re-transplantation in 21 recipients. Induction immunosuppression was mainly with antithymocyte globulin, and the diagnosis of acute graft rejection was based on histopahtological findings. Recipients were followed up for 3 months to 123 months. Primary graft function was observed in (79%) of cases. Pos-transplantation complications were: (a) 74 (38%) surgical, (b) 36 (19%) systemic bacterial and viral infections, (c) 47 (30%) episodes of acute rejection, and (d) 4 (2%) cases of malignancy. Twenty-three recipients died with functioning graft at 1 month to 62 months after transplantation, and 32 more grafts were lost at one day to 87 months after transplantation. The 5- and 10-year actuarial survival rates were 88% and 88% respectively for recipients, and 75% and 71% respectively for grafts. The kidney transplantation programme in Kuwait is steadily growing. Kidney grafts procured from cadaveric donors contributed to 28% of transplantation activity and were associated with a high rate of primary function. The overall actuarial recipient and graft survival rates were comparable to those reported by other larger centers.