Tuberculosis (TB) is an important infection after transplantation especially in developing countries. We studied the risk factors and impact of TB on the outcome of kidney transplantation. We retrospectively analyzed the cases of TB infection in a series of 1600 renal transplants carried out in our center from March 1978 to March 2004. Demographic parameters and clinical antecedents were considered. Moreover, the clinical onset, diagnosis tools, treatment policy and evaluation were studied.In the course of an 18 years period, there were 71 cases of TB (4.4%). The mean elapsed time from the transplantation was 61.5 months; 7 of them during the first year after transplantation. The clinical onset was urinary in 43 cases (60.5%); 21 (29.6%) had pulmonary infection; 6 cases had disseminated infection. Most of patients were CsA treated. All post transplant TB patients received triple antituberculous therapy (rifampicin, ethambutol and INH) with favorable microbiological response except in two who need another course for 24 months. Throughout the follow-up period, the graft function remained stable in 42 patients (59%). Hepatotoxicity was seen in 14 patients but with no mortality attributable to hepatocellular failure. Twenty one patients died, 19 of them due to causes not related to TB or treatment. TB is a common infection in renal transplant recipients and urinary TB infection is more prevalent in our transplant population. Chronic rejection is a serious complication in these patients which had a negative impact on the graft survival especially in CsA treated recipients.