Renal transplant is acknowledged as preemptive if it occurs before the initiation of dialysis. In our experiences and in the literature, preemptive transplant has been shown not only to reduce the costs of renal replacement therapy but also to avoid long-term adverse effects of dialysis. Preemptive transplant therefore is associated with better survival of both the allograft and the recipient. Our aim in this study was to evaluate the outcomes of preemptive renal transplant experience at our center. Since 1985, 1385 renal transplants have been done at our center. The transplants of 16 of these 1385 patients (11 male, 5 female; mean age, 28.5±15 years) were preemptive in nature, and these patients were analyzed retrospectively. The causes of end-stage renal failure were focal segmental glomerulosclerosis in 5, vesicu ureteral reflux in 4, Berger’s disease in 2, polycystic renal disease in 2 and other in 3 patients. Ten patients were adult, the remaining 6 were children. The mean plasma creatinine clearance and creatinine level of the preemptive recipients before transplant were 13.5±8.5 mL/min and 6.7±2.4 mg/dL, respectively. All renal transplants were done from a living-related donor. The mean preoperative serum creatinine levels, mean glomerular filtration rate, and creatinine clearance rates of the donors were 0.8±0.1 mg/dL, 61.6±6.5 mL/min, and 112.5 12 mL/min, respectively. Three acute rejection episodes (18.7%) occurred during a mean follow-up of 48.7±14 months (range, 25-76 months). Two patients required retransplantation owing to acute humoral rejection and chronic rejection 2 and 48 months after the initial renal transplant. At the time of this writing, all patients are alive with good renal function. In conclusion, our single center results are promising for preemptive transplant as the optimal, least-expensive mode of treatment for end-stage renal disease.