We present the case of a 47 years old women with a third cadaveric kidney transplant. After surgery, she had effective diuresis reaching a serum creatinine of 2.2 mgs% at 19 postoperative day. In the nest few days, the patient was oliguric with worsening of renal function. The ultrasound examination excluded urinary obstruction. With the suspicion of acute rejection, a renal biopsy was performed. The histopathological record disclosed cholesterol emboli with a widespread multifocal ischemic infarct and eosinophilic tubulointerstitial nephritis. The renal function deteriorated in the seven next days and peritoneal dialysis was carmedow. She then recovered diuresis with improvement of renal function, reaching at discharge a serum creatinine of 1.8 mgs%. The renal function remains stable after 3 years. We analysed the etiopathogenic factors of this disease and the possible beneficial effects of immunosuppresive drugs in better prognosis compared with the same entity in native kidneys.