Hyperinfection strongyloidiasis is a potentially fatal disease associated with conditions of depressed host cellular immunity. High degree of suspicion is required to pick up cases early and avoid fatal outcome. During the period from 29/09/2004 till 30/11/2004 we had 3 cadaveric kidney transplant recipients died from hyperinfection strongyloidiasis within a short time. All members of the transplant team, microbiology department and infection control office were involved in a campaign to localize the source of infection, identify and treat infected patients and provide adequate prophylaxis to other transplant recipients. Cadaver donors' files were reviewed. Screening for possible infected persons included 61 personnel (working for cleaning, food preparation and food handling), 27 hospital inpatients during the screening period and 87 patients transplanted in a year time before that event. The screening test was analysis of fresh stool samples on 3 consecutive days from each person. Albendazol (an anti-helminthic drug) was given to all patients under screening and they were followed up for possible development of the disease during the infectivity period. The first two recipients received their kidneys from one cadaver donor while the third one received it from a different donor. Both donors came from areas endemic for strongyloidiasis. The 3 recipients were on tacrolimus based immunosuppression. The couple of the third patient was on cyclosporine and she did not manifest a disease. All stool samples taken for screening were negative for the infective larvae. None of the other recipients developed the disease.Cadaveric donors were the possible source for this outbreak. Cyclosporine probably has a protective effect against strongyloides. Screening of cadaver donors for strongyloides is mandatory before accepting them for donation. Prophylaxis is required for all cadaver recipients.