Renal transplantation is a definitive treatment for end-stage renal failure. Despite economic limitations, patients with a failed primary graft still opt for a second renal transplant for better rehabilitation and an improved quality of life. Our report describes the outcome of renal retransplantation at this institution. Over a 10 year period, 418 renal transplants were performed, 395 being primary. Twenty-three patients (18 male, mean age 46.5 yr, 22 living unrelated donors) underwent a second renal transplant after loss of their primary graft (chronic rejection 15, non-compliance 4, technical failure 2, hyperacute rejection 1, cardiac arrhythmia 1). The immunosuppressive regimen included prednisone, azathioprine and cyclosporin. Satisfactory 1 and 3 year patient and graft survival were noted. 1 yr patient and graft survival 90% and 86% and 3 yr patient and graft survival 69% and 62% respectively. Graft loss after retransplantation occurred in 6 patients primary non-function 2, chronic rejection 2, pulmonary infection 2. The results are encouraging and we suggest that repeat renal transplantation be offered to patients with a failed primary graft as an alternative to life-long dialysis.