A high incidence of cancer has been reported following organ transplantation. This study explores the incidence, clinical presentation and outcome of post transplantation lymphoproliferative disease (PTLD) in renal transplant (KTx) recipients. 1290 kidney recipients have been followed up in the centre between May 1972 and December 2005. Of these, 785 were males and 119 were under the age of 18 years. The donor source was a living donor (LD) in 1046 and a cadaver donor (CD) in 244 cases. The medical records of recipients with PTLD were retrospectively reviewed. 16 instances of PTLD were diagnosed in 15 recipients at 3 to 192 months [mean 84 months] after KTx, with a disease incidence of 1.2%. Recipients with PTLD were 9 males and 6 females, aged 15 to 58 years, and obtained Kidney grafts from 12 LD and 3 CD. Organs involved with PTLD were: small intestine in 6, brain in 6, and cervical and mediastinum lymph nodes in 2 recipients. The remaining 2 lesions affected the breast and maxillary sinus in one recipient. Three (20%) recipients are alive for 12 to 41 months following PTLD diagnosis (2 with functioning graft and one on dialysis therapy). Twelve patients died (80%) at 1 month to 72 months following PTLD diagnosis (10 with functioning graft and 2 while on dialysis. In the present series of kidney recipients [1] PTLD was the most common form of post KTx cancer, but with a lower incidence in comparison to other reports. [2] Incidence was not influenced by recipient gender, age or the donor type. [3] PTLD can appear as early as 3 months or as late as 192 months after KTx, [4] Post transplantation PTLD was associated with poor patient and graft survival rates.