To evaluate the rate and causes of unused organs in five-year period. A retrospective study was done during the period of 2001-2005, comprising the cases consented for organ donation, harvested/transplanted and consented not harvested. Organs involve were kidneys, liver and heart. From the total of 1827 reported cases as potential brain death (BD), 956 (52.3%) were approached for organ donation after declaration of BD, and 270 (28.2%) were consented for organ donation with 247 (91.5%) harvested, while 23 (8.5%) were rejected. From the 247 harvested cases, 100% were consented for kidney donation including cases from organ sharing program with GCC countries and Spain. There were 414 kidneys retrieved locally, 400 of them were transplanted (96.6%), and 14 (3.4%) were not used. All in all, 253 (93.7%) cases were consented for liver donation, 121 (48%) of which were rejected for harvesting mainly due to hypernatremia and elevated liver enzymes, 132 (52%) cases were harvested while 101(76.5%) were transplanted with 31 (23.5%) unused. There were 239 (98%) consented for heart donation with only 158 (68%) were used as 22 whole heart and 136 used as a source for valves. The rate of rejection to harvest were 8.5% for kidneys, 48% for liver and 32% for heart, mainly as a result of the donor qualities, while the rate of unused organ after harvesting is around 18%, usually due to characteristics itself. Still, we could lessen the rate of rejection by preventing technical reasons and the much needed improvement in the area of donor management.