Transmission of cancer from organ donor is considered as a serious risk following organ transplantation. We describe a case in which a kidney with renal cell carcinoma was transplanted after resection of tumor. A 12 years old female with end stage renal disease secondary to reflux nephropathy has been treated with peritoneal dialysis was considered for renal transplantation. The recipient’s mother 48 years old was evaluated for living related kidney donation. Preoperative evaluations didn’t show any contraindication for kidney donation, and imaging studies from donor’s kidneys were normal. The mother’s left kidney was removed uneventfully. During backtable preparation a 5x5 mm nodule found on the surface of the kidney and excised totally prior to transplantation and sent to routine histology. The mother’s kidney was transplanted uneventfully to the recipient. Primary graft function was normal in the recipient. Immunosuppressant consisted of cyclosporine A (CSA), mycophenolate mofetil (MMF) and prednisolone. In pathological examination renal cell carcinoma grade I in furhman grading system was reported. The allograft remained in place. An acute rejection episode occurred on 14th day after transplantation with good response to methylprednisolone. The post operative course was uneventful and the patient discharged on 22nd day with plasma creatinine (Cr) 0.7 mg/dl. Post transplantation diabetes mellitus occurred in second month after transplantation which treated with insulin. After 14 months the mother is without any evidence of tumor recurrence. In the recipient, repeated ultrasounds and CT scans of the abdomen showed neither signs of local cancer recurrence nor metastases. Current immunosuppressive drugs consist of CSA, MMF and prednisolone. Plasma Cr is 0.8 mg/ml. So far, no rejection episodes have been observed. This experience indicates that donor kidneys with small, low grade RCC may be managed with excision and transplantation, without tumor recurrence in recipient.