The number of elderly patients accepted in renal replacement programmes is increasing. There is a general agreement that age per se does not constitute a contraindication to transplantation. Yet many centres are still reluctant to accept patients >60 years old, as they are frail, have more comorbid conditions and their overall life expectancy is lower. The aim of this study was to investigate whether or not transplantation provides any survival benefit in this group of patients. This study is a retrospective case control analysis study in elderly patients (GrI; >60 years). Data were collected from 11/1993 till 5/2003.Data were compared to those obtained in patients (GrII) who were matched for HLA mismatches and time of follow up but not with recipients'age(20-50). Primary end points are Graft loss and/or patient death, while secondary end point are Cerebro-cardiovascular events,malignancies or rejection. Thirty-two patients with mean age (±SD) 63.4 (±3.2), ranged from 60 to 73 years old (11 females and 21 males) were compared with 32 patients with mean age (±SD) 33.5 (±7.46) ranged from 21 to 50 (11 females and 21 males). There is no statistically significant difference between the 2 groups in the result of mean s.creatinine after 1 year while mean s.creatinine after 3 years in GrII is significantly higher than GrI (p<0.003) and prevelance of malignancy was similar in both groups (one patient in each group). Seven graft were lost in GrI (6 due to patient deaths and 1 from trauma) while only 1 was lost in GrII (due to renal vein thrombosis) (p<0.01). Elderly age was associated with lower number of graft losses due to rejection, while they had higher death rate result in significantly worse overall renal transplant survival.