Middle-East is the biggest host of refugees in the world. The total number of refugees in this region is estimated to be more than 4 billions in the year 2006. Most of these people are from low socioeconomic classes. Economical and social barriers are the major obstacles for accessing the healthcare facilities in the hosting countries. So it would not be surprising to find that refugees have problems accessing to one of the most sophisticated and expensive medical procedures in the world, the kidney transplantation. There is no precise data available on kidney transplantation in refugees, neither regional, nor worldwide. This is while the refugees are mainly involved in kidney transplantation. As the recipients, socio-economic problems make kidney transplantation an unreachable procedure for them. As the donor; there are always middle-men and human traffic mafia out there for such poor and unsupported groups. So, it’s the hosting countries’ responsibility to protect this population against such problems. The type of protection needs to be defined locally, but it could be predicted from previous experiences. Allowing the refugees to receive a transplant is the most primitive kind of support. Financial supports come after that. Providing good follow-up facilities make the precious graft last longer. The law must also protect them from being organ reservoir for black market. To date, there are data available from few MESOT countries on their kidney transplantation regulations: Iran, Saudi Arabia, Pakistan and Turkey. Despite their shortcomings, it’s a step forward toward supporting refugees for kidney transplantation. Other countries in the region must design such models, based on their own local conditions and the experience of other models. Having an international committee on this specific issue would be of outmost usefulness.