Urinary tract infections (UTIs) are one of the most important causes of mortality and morbidity in patients undergoing renal transplantation. A number of risk factors for the development of UTIs have been studied. Despite this, the significance of asymptomatic bacteriuria remains ambiguous. We therefore conducted a a prospective cohort study at the Sind Institute of Urology and Transplantation (SIUT) to evaluate the role of early post-operative bacteriuria in the development of future symptomatic UTIs. All patients undergoing a renal transplantation between the January 1st 2004 and 31st December 2004 were included. Urine cultures were obtained regardless of symptoms, in the first 10 days posttransplantation and designated as “surveillance cultures”. Additionally the Foley catheter tip was also cultured on removal on the fifth post-operative day. For the next 6 months, follow-up urine cultures were obtained periodically. Out of 107 patients included, 14 (13.3%) had a positive surveillance culture. These patients developed a UTI earlier and more frequently than those with a negative surveillance culture (71% vs. 28%, RR=2.5, 95% CI 1.6-4.1, p=0.002; 50% UTIs in 10 days vs. 24 days). Similarly a positive Foley tip culture was an independent risk factor for development of a UTI (RR=2.2, 95% CI 1.3-3.6, p=0.003). On the other hand, sex and, presence or duration of a Double-J stent were not found to be a risk factors. Early post operative bacteriuria is a risk factor for the development of UTIs in the renal transplantation patient. Routine surveillance of these patients may be useful, although further study is required to ascertain the benefit of treating the bacteriuria in preventing UTIs.