Pediatric kidneys accounted for only 1.7% of renal allografts performed in 1991 (UNOS 8:35, 1992). A technique for preparation and transplantation of en bloc infant kidneys, which has been applied to 54 recipients, is described. Technical complications were minimal. At three year follow-up, graft survival and serum creatinine were 68% and 1.2 mg/dl, respectively. Graft utilization increased to 13.4%.