In laparoscopic donor nephrectomy, the presence of vascular anomalies remains challenging for the surgical team. In this study we show the outcome in donor and recipient of in cases with vascular anomalies. Between March 2003 and August 2006, 400 cases of laparoscopic donor nephrectomy were performed in our institution. Donors were evaluated as regards renal vasculature using CT renal angiography. We used the left kidney in 329 patients and the right kidney in 71 cases. All cases were performed trough transperitoneal route. Fifty-six cases had double renal arteries (left side n=52, right side n=4). In forty-two cases we anastomosed the two arteries separately into the iliac artery. In fourteen cases, we joined the spatulated edges of the two arteries to create a single bifurcating artery that was anastomosed end to side to the common or external iliac artery. Two patients had triple renal arteries (In one case we ligated one artery and the other we did separate anastomosis to the three). Seventeen cases had venous anomalies (retro-aortic n=11, double renal n=4, circumaortic n=2). Vein were anastomosed to the external iliac vein. All cases were completed laparoscopically with no open conversion. The mean operative time was 124±32 min. The mean blood loss was 65 ± 38 cc, and none of the donors required blood transfusion. The mean warm ischemia time was 2.6±0.4 min. Mean renal artery length was 3.1±0.4 cm. The mean renal vein length was 3.5±1.2cm. Donors were discharged on second post-operative day. None of the donors required readmission. Kidneys were transplanted successfully and mean creatinine of the recipient on discharge was 1.3±0.7 mg/dl. One patient with double renal arteries had thrombosis of the smaller artery just after the anastomosis. Five patients had ATN however only one of then required dialysis. Kidney function recovered there-after in all of them. In patients with double renal veins, we ligated the smaller of the two veins with no problems. Laparoscopic donor nephrectomy is safe for donors with vascular anomalies. Donors will benefit from a less morbid procedure with no affection of the functional outcome.