Chronic dialysis and renal transplantation are both satisfactory treatment for end-stage renal disease (ESRD). Successful renal transplantation remains the primary goal for children with ESRD. In this study we reported our experience with renal transplantation in patients younger than 18 years in our pediatric nephrology center. We enrolled all children managed for ESRD and received renal transplantation during 9 years period (1376-1385) in our hemodialysis center. The diagnosis of ESRD was based on clinical, laboratory and radiological findings. The demographic characteristics of patients and graft survivals were collected and reported. Forty-four renal transplants were performed in patients less than 18 years of age in this period. 27 (61%) were boys and 17 (48%) were girls. The mean age at transplantation was 12.3±1.1 years. Twenty-seven (61%) were from living donors (81% unrelated, and seven (39%) were from cadavric donors. The main etiology for end-stage renal disease was nouropathic/ vesicoureteral reflux in 38% of the children, followed by gromerulopathy in 13.6%, nephrolitiasis 11% and polycyctic kidney 6.8%. The rate of graft losses was 16% (3 patients with living unrelated donors, 2 with living related and 2 with cadavric donors) and the mean age of patients for graft failure was 8.4 years. The etiology of ESRD in patients with graft losses were; nephrolithiasis due to hyperoxaloria (3), nropathic VUR (3) and Alport syndrome (1). These findings suggest that the graft survival of living unrelated donor renal transplantation in recipients is the same as cadaver donor renal transplantation. Furthermore, the main factors for the graft losses were younger age and causative disease.