We review 171 anterior transperitoneal live donor nephrectomies. The transperitoneal approach provides optimum exposure for atraumatic dissection of the kidney and renal vessels. The total and major postoperative complication rates were 30.4 and 3.5 per cent, respectively. These results compare favorably to reported series of extraperitoneal live donor nephrectomies. Transperitoneal live donor nephrectomy is a safe and effective operation with low risk to the donor.