The growing shortage of cadaver kidneys available for transplantation (Tx) compared to the increasing demand has led to an increase in the acceptance of living unrelated donors by the transplantation community. This is a retrospective study of the results of renal transplantation from live unrelated donors (LURD). Between November 1993 and May 2006, 678 kidney transplantation procedures were performed, of these 227 (33.5%) grafts were obtained from live unrelated donors [185 altruistic and 42 emotionally related]. Recipients were 170 males (75%) and 54 females (25%), aged 22 to 56 years. Altruistic donors were interviewed by, and satisfied, a special committee with their motives. Induction therapy was with ATG or simulect. The medical records of all LURTx recipients were retrospectively reviewed. LURDs were followed up regularly, with no mortality or significant morbidity. All of them enjoy normal kidney function, are fully rehabilitated, and back to work. In recipients, 63 instances of surgical complication (27.7%) were detected, and were in the form of 35 peregraft collection (lymphocele or haematoma), 20 wound related, 7 urological problems, and one vascular thrombosis. Post Tx malignancy was diagnosed in four recipient (three PTLD and one rabdomyosarcoma of urinary bladder). Nine recipients died with functioning graft at 5 days to 13 months after Tx, with one and ten years actuarial recipient survival of 97% and 96% respectively. Another six grafts were lost at 7 days to 48 months giving actuarial graft survival of 95% and 93% at one and ten years respectively. These results are comparable to those obtained in living related transplantation and superior to those in cadaveric transplantation Providing guaranteed altruism and absence of commercialization, LURD represent a viable and important source of kidneys for Tx, in view of; (1) the excellent recipient and graft survival rates, and (2) the negligible donor mortality and morbidity.