In young patients, kidney transplantation improves the quality of life, and increases patients' survival, but in old patients, such benefits are not apparent. Our aim was to compare the outcome of kidney transplantation between the old and young recipients. In this historical cohort at Baqiyatallah hospital, we enrolled 44 kidney recipients in Group I (≥60 years old) and 358 recipients in Group II (<60 years old). We used one protocol for assessment and treatment of both groups. All the recipients had a normal creatinine level (<1.5 mg/dl) on entry to our study. We followed the recipient's serum creatinine level, graft and patient survival for 5 years. Graft survival was determined under both death censored and uncensored approaches. The findings of the two groups were compared at the time points of 6 months, 1 year and 5 years. There was no significant difference in the serum creatinine level between the two groups, in all time points (p>0.05). Patient and graft survival in 6 months was not statistically different between the two groups (P>0.05), whereas at the 1 year and 5 year time points, patient and death-uncensored graft survival was significantly worse for patients above the age of 60 (p<0.05). However, death-censored graft survival was similar between the two groups (p>0.05). Due to the similar death-censored graft survival in the old and young kidney recipients, it may be regretful to exclude the patients on the basis of their age from receiving a kidney. This needs to be promoted by the experienced transplantation team for older patients with ESRD.