We report our experience with renal transplantation in 38 children (40 transplants) of ages 1 to 5 years old, performed between 1989 and 2005. Demographics, patient and graft survival are reported. At the transplant the mean age was 3.3+1.3. The mean weight was 14kg (range from 5.4 to 25). 92.5% were caucasians, 7.5% african-brazilians. Main etiology of ESRD was uropathy/vesicoureteral reflux (45%), followed by glomerulopathy (25%), congenital/hereditary diseases (10%), and hemolytic uremic syndrome (12.5%). Prior to transplantation, 5% were under hemodialysis, 85% peritoneal dialysis and 10% were preemptive All children were followed at least 6 months post-transplantation, except 2 who died in the first month. Kidneys were obtained 67.5% from living related donors and 27.5% from deceased donors. 39 kidneys were placed extraperitoneal. The primary immunosuppressive therapy consisted of cyclosporin (61%), tacrolimus (39%), and mycophenolate (48.8%) without prednisone in 17%. In the last 21 cases, basiliximab or daclizumab were added. There were 13 (32.5%) graft losses (3 artery/vein thrombosis, 3 chronic rejection, and 3 deaths, 4 others). The 5-year patient and graft survival rates were 85% and 68%. We conclude that renal transplantation can be performed with good long-term results in children less than 6 years old.