Renal transplantation is considered the optimal form of renal replacement therapy for patients with end stage renal disease. Kidney transplantation was started in Bahrain in 1995 at our unit. Between June 1995 and June 2008, 90 renal transplants in 89 patients were performed at our unit. There were 72 living related donor and 18 deceased donor transplants (DD), including 61 male and 28 female patients. Most of the recipients were Bahraini (87.5%) and 86 (95.6%) of them received their first graft. Their age ranged from 3 to 66 years and the follow up period was 1 to 156 months postoperatively. The average duration of dialysis before transplantation was 4 to 5 months. All patients received triple drug immunosuppression and induction therapy with Basiliximab. There were a total of 22 (24.4%) episodes of acute rejection diagnosed clinically and/ or by- graft biopsy. Most of the rejection episodes occurred within the first month of transplantation and almost all of them within the first year of transplantation and all episodes of rejection were treated with pulse methylprednisolone. Six (6.7%) grafts had primary non-function due to acute tubular necrosis (ATN), and all of them were from DD. There were 15 episodes of severe infection. Seven patients died from their infection including three due to severe respiratory tract infection. Three patients developed CMV infection which was diagnosed on clinical and serological grounds. One patient had malignancy which was treated successfully. There were 3 surgical and urological complications encountered in our patients. At the last follow-up visit, there are 52 patients have good graft function. Twenty-two patients lost their graft, 16 of them due to death with functioning grafts. The commonest cause of graft loss was chronic rejection. In conclusions, the overall results in our center are comparable to those published from other centers in the Arab World.