The children with bladder dysfunction who underwent renal transplantation have difficulties in treatment. Bladder dysfunction leaves the bladder unsuitable for urine drainage in a significant proportion of children presenting for kidney transplantation. We retrospectively reviewed the outcome, medical and surgical outcome of 43 recipients with augmentation cystoplasty. We divided our patient into two groups: patients who underwent renal transplantation before or after augmentation cystoplasty. Augmentation cystoplasty was performed before transplantation in 21 patients (Group 1) and after transplantation in 22 patients (Group 2). These groups compared with control group (45 patients with medical etiology who underwent renal transplantation). The actuarial graft survival at 1, 3, 5 and 7 years was 90%, 76%, 65% and 43% respectively in group 1 (pre-transplantation cystoplasty) and 94%, 61%, 50% and 40% in group 2 (post-transplantation cystoplasty). The graft survival was not different significantly between these two groups. The actuarial graft survival at 1, 3, 5 and 7 years was 94%, 87%, 81%, and 75% respectively in control group. Graft survival rate at 3, 5, 7 years after transplantation were better significantly in control group (P<0.05). Febrile UTI was seen in 5/21 (24%) of patients in group1 (Pre-transplantation cystoplasty), 6/22 (27%) of patients in group 2 (post transplantation cystoplasty), 1/45 (2%) of patients in control group. Febrile UTI was less significantly in control group in relation to cystoplasty group, but was not different between group 1 and 2. Acute rejection was seen in 9/21 (43%) of patients in group 1, 9/22 (41%) of patients in group 2, 15/45 (33.3%) of patients in control group (P=0.2). Chronic rejection was seen in 11/21(52%) of patients in group1, 11/22 (50%) of patients in group 2, 13/45 (29%) of patients in control group. Chronic rejection was less significantly in control group (P=0.03) but not different between groups 1 and 2 (P=0.1). Surgical complications were seen in 4 patients. These included: paunch rupture in 2 patients, anastomosis leak in one patient and uretrovesical junction stenosis in one patient. The distribution of complications was not different between groups 1 and 2. Cystoplasty is a safe surgery in children with renal transplantation. Pre and post transplantation cystoplasty does not have any effect on outcome and rate of complications after transplantation.