Although several studies have demonstrated a relationship between mental health and utilization of health care in other chronic illnesses, such evidences is lacking in post transplant patients. This study aims to investigate the effect of depression – as a common psychiatric co morbidity- after kidney transplantation, on health care utilization. This cohort was held on 99 patients with a first-time kidney transplant (between 6 months and 1 year before enrollment) in Baqiyatallah Hospital (Tehran) between 2004 and 2006. From these, 78 (79%) patients finished the study. These patients were followed up for one year, for health care utilization (HCU) including the number of hospital admission days, and the frequency of home nurse visits, outpatient physician visits and patient’s emergency department visits for any medical reasons. These patients were grouped into Group I (with depression; n=14) and Group II (without depression; n=64), according to Hospital Anxiety and Depression Scale (HADS). The two groups were matched for age, sex and somatic comorbidities measured by Ifudu comorbidity index (p>0.05). Results: Frequency of emergency department visits was significantly higher in patients with depression (71.4% vs. 35.9%, p=0.01). Outpatient physician visits, hospital admissions and home nurse care were not significantly different between the two groups (p>0.05). In conclusion, depression not only affects the kidney transplanted patients themselves, but also puts the health care system under economic pressure. We recommend screening of all renal transplanted subjects for this common psychiatric comorbidity, and treating it when diagnosis is made. Such effort may reduce the health care system’s economic burden.