Thirty renal transplants have been done in 25 patients with end stage polycystic kidney disease. All but 2 allografts were from a cadaver donor and the average followup was 5 plus or minus 0.9 years. THe 1 and 5-year patient survival rates after transplantation were 76 and 50 per cent, respectively, and allograft survival rates were 63.3 and 39.1 per cent at the same intervals. Of 14 patients at risk for more than 8 years 6 still have well functioning allografts. Nine patients underwent transplantation with both polycystic kidneys in situ and with no adverse sequelae resulting from the retained native kidneys. Despite the risk factors inherent in an older than normal population of cadaver allograft recipients, renal transplantation is an excellent method for treating end stage polycystic kidney disease and holds the prospect for long-term allograft and patient survival rates.