A novel technique to obtain renal biopsy specimens from patients in whom percutaneous renal biopsy is contraindicated is described. After adaptation of equipment used for transjugular liver biopsy, 50 such patients underwent transjugular renal biopsy: specimens of renal tissue were obtained from 44 patients, and glomeruli were found in 38 specimens. No major complications were observed and histological examination of the biopsy specimens led to changed diagnosis or management in 13 patients. Transvenous renal biopsy should be considered when percutaneous biopsy is contraindicated or has failed.