From January 1987 to August 1995, a total of 89 consecutive segmental pancreas transplants with bladder drainage were performed for end-stage diabetic nephropathy, the majority of them together with a kidney. One-year patient, pancreas, and kidney graft survival was 92%, 82%, and 87%, respectively. Rejection accounted for 64%, and thrombosis for 30% of total graft losses. While there was an increased risk of pancreas graft thrombosis, compared with duodenal pancreas transplantation, we experienced a lower incidence of urinary tract infections. In our series, segmental pancreas transplantation gives excellent long-term results.