Opportunistic infections are leading cause of morbidity and mortality after renal transplantation. While Bacterial and viral infections are very common after transplantation protozoa infection are less commonly seen in these patients. Herein we report a case of cutaneous leishmaniasis that is a 15 years old girl transplanted in September 1997 from a 23 years old living unrelated donor (LURD). Immunosuppressive medications after transplantation consist of prednisolone and cyclosporin A with levels maintaining between 150 and 200 ng/ml. immediately after engraphment and Mycophenolate mofetile lateron when the infection was subsided. The graft is working perfectly with creatinine of around 1.1 mg/dl. Fifteen month after transplantation she developed a pustular lesion on her left middle finger progressing gradually to a large purulent and some crusted lesion up to her elbow with a disfigurring worrisome appearance. Treatment was started with Cryotherapy and injections of glucantim at the border of the lesion. The wound started to regress after about 6 month of therapy leaving a smooth surfaced scar. After 3 month of complete healing relapse of the lesion became evident in the centre of the scar with a volcanic appearance. Cryotherapy again was started with N2 with a slow regression of the lesion. There were multiple relapses and flare up of the lesion up to now but she is free of flare up of the lesion for two years now. Cutaneous leishmaniasis should be considered in differential diagnosis of skin diseases after kidney transplantation in endemic regions.