Kidney transplantation is the treatment of choice for children with end-stage renal disease. In Iran, a kidney transplantation program was started in the Labfi Nejad Hospital, Tehran in 1985. From 1985 to 2007, 320 children (mean age 11.52 years, 58.5% males) received their first renal transplant. All transplants were donations from live donors (7.4% live-related donors); 31% of patients were preemptively transplanted. The surgical complications were seen in 3% of patients. Three patients involved by malignancy in follow up period. The median graft survival time was 7.2 years. The rate of graft survival was 91% at 1 year, 83% at 3 years, 73% at 5 years, 65% at 7 years, 50% at 10 years and 37% at 12 years after transplantation. The survival rate of transplants improved significantly with time (p<0.05). In patients transplanted before 1993, the 5-year graft survival was 40% , 76% in patients between 1993 till 2000, and 80% in patients transplanted after 2000.. At the same time intervals, the frequency of acute rejection episodes was 80% versus 59.5% and 34.6% (Pv<0.0001). Graft survival was negatively correlated with the frequency acute rejection episodes. In conclusion, graft survival in transplanted children significantly improved with time in Iran, thus reflecting greater medical and surgical experience, new immuno­suppressive drugs, and better compliance. We are collecting the data of renal transplantation outcome in all pediatric renal transplantation centers in Iran and it will be ready till the congress beginning, thus this report will be corrected from multicenter data. This study can be a report of pediatric renal transplantation condition and outcome in Iran.