Background <p>Living-donor kidney transplantation is widely accepted as the optimal therapeutic option for patients with end-stage renal disease. Despite substantial progress in surgical methods and perioperative management, early surgical complications remain an important cause of morbidity, particularly in developing transplant programs.</p> Methods <p>We retrospectively analyzed 35 consecutive living-donor kidney transplantations performed between January 2020 and December 2024 at a single center. Early surgical complications occurring within six weeks after transplantation were classified as vascular, urological, lymphatic, or wound-related. All donor nephrectomies were performed laparoscopically, and recipients were managed using standardized immunosuppressive and postoperative surveillance protocols.</p> Results <p>Early surgical complications occurred in 26.7% of recipients. Vascular complications (6.3%) included renal artery stenosis, arterial thrombosis, and graft renal vein thrombosis. Urological complications (7.5%) consisted of ureteral kinking, urine leakage, and vesicoureteral reflux. Lymphatic complications (8%) presented as lymphoceles and were successfully treated with percutaneous drainage. Superficial wound infections occurred in 3.1% of cases. Delayed graft function was observed in three recipients and was associated with prolonged cold ischemia related to complex reconstruction. Grafts affected by established graft renal vein thrombosis were not salvageable.</p> Conclusions <p>Early surgical complications remain common following living-donor kidney transplantation. Prompt diagnosis, timely intervention, standardized postoperative care, and experienced multidisciplinary transplant teams are essential to optimize outcomes.</p>