Horseshoe kidney is probably the most common renal fusion anomaly. Horseshoe kidneys have been successfully transplanted en bloc into a single recipient or, alternatively, they have been divided and implanted into 2 patients. Despite these facts the use of horseshoe kidney allografts for transplantation is rare. We report a case of the successful transplantation of an en bloc horseshoe kidney into a single recipient. The evaluation of fused kidneys for transplantation, technical considerations and previously reported cases are discussed.