A total of 432 patients in Qatar received renal transplant (RT) from1986 through 2002 at Hamad Medical Corporation (HMC) as well as abroad. The recipients were of mixed nationalities, 238 Qatari national (Q) and 194 expatriates (NQ). Since 1986 when we started our local transplant program, 70 cases were performed at our center and 362 performed abroad. Diabetic nephropathy was the most common cause of end stage renal disease (ESRD) in Q transplants patients (23.9%), while chronic glomerulonephritis was the most common cause of ESRD in NQ (28.7%). New onset diabetes was reported after the transplant operation in 7.3% of the total cases. Recipient age ranged from 14 to 75 years with the mean age 48.5 years in diabetics and 34.5 years in non-diabetics. Immunosuppressive therapy included cyclosporine azathioprine, mycophenolate mofetil and steroids. Post-transplant acute rejection was reported in 9.7% of all cases and chronic rejection developed over the years in 14.3%. Two years survival at our center compared to other centers abroad was 98%, 97% for patients and 85.7%, 82.5% for grafts respectively. Mortality in the 432 patients was mainly related to cardiovascular disease accounting for the death of 24 cases (5.5%). In the 88 diabetic patients 11 cases suffered a fatal myocardial infarction (12.5%) compared to 13 cases of myocardial infarction in the 344 non-diabetic patients (5.3%). Other causes of mortality such as sepsis, hepatic failure, and cytomegalovirus infection did not differ significantly in diabetic patients compared to non-diabetics.