From 1971-1990, 51 patients underwent renal transplantation with a kidney from a cadaver donor more than fifty-five years of age. Following transplantation, 19 kidneys (37%) functioned immediately while initial nonfunction occurred with 32 kidneys (63%). The one-year graft survival rate for kidneys with immediate function versus initial nonfunction was 84 percent and 63 percent, respectively. Graft survival was significantly impaired by increased recipient weight (p < 0.05) and by an elevated donor serum creatinine level (p < 0.05). We conclude that well-functioning kidneys from older donors can be safely and successfully used for renal transplantation. Such kidneys appear to be more susceptible to ischemic damage and should not be used when the donor serum creatinine level is elevated.