In this contribution the emergencies related to renal transplantation were addressed. Surgical emergencies during kidney donation from a living subject should not be under estimated and were presented. Emergencies following renal transplantation were classified according to their nature and time of their onset. The importance of early diagnosis followed by immediate intervention was emphasized. Ultrasound examination can give a diagnostic clue to many of such complications. Endourologic tools particularly percutaneous nephrostomy played an important role in the salvage of the transplanted kidney and saved the recipient from a second open surgical intervention.