Background & Aim: Previously, patients with end stage renal failure(ESRF) and lower urinary tract abnormality(LUTA) were often considered high risk for renal transplantation. In order to examine the degree of risk, 48 patients who received renal transplants in Labafi Nejad Hospital were evaluated between 1986 and 2003. Patients & Method: In this retrospective cohort study, the mean age of the patients was 11.5 years in both case and control groups. Girls comprised 35% of the subjects and boys 65%. Urologic anomalies included posterior urethral valves in 4 cases, ureteral obstruction in 4 cases, and neurogenic bladder in 40 cases. Results: Among the subjects of the control group, 2.3% had hyper-acute rejection, 59% acute rejection, and 35% chronic rejection. In patients with LUTA, 8% showed hyper-acute rejection, 75% acute rejection, and 39.5% chronic rejection. However, there was no significant difference between these two groups(hyper-acute rejection: Pv=0.11, acute rejection: Pv=0.52, chronic rejection: Pv=0.29). Graft failure was seen in 33%(16 out of 48) of the patients. This value was the same in children without LUTA who underwent renal transplantation. The mean survival period was 6 years in patients with LUTA and 7.3 years in the control group. This difference was not statistically significant, though(Pv=0.7). In patients with LUTA, the rate of graft survival in the first year after transplantation was 90% rates for the third, fifth and seventh years after transplantation were 76%, 65% and 40% respectively. In the control group, graft survival rate was 88% in the first year, 73% in the third, 70% in the fifth, and 49% in the seventh year after transplantation. Conclusion: Graft survival rate was the same in both groups.