A matched case-control study was performed to compare the prognosis of six renal transplant recipients with a control group of non-transplant patients, both groups presenting with native kidney tumors. Patients were matched for age, gender, neoplasm histology, and TNM classification. The follow-up ranged from 8 to 131 months (median 32 months) after nephrectomy or nephroureterectomy of the native kidney. Five out of six recipients retained good graft function. No evidence of recurrent local disease or distant metastasis of kidney neoplasms was observed in either group. In the transplant group, two patients developed basal cell carcinoma, and one, lung cancer and a disseminated lymphoma. Among control group patients, prostate and bladder cancer were noted. Prognosis of early-stage kidney malignancy in the transplant and non-transplant group was comparable despite immunosuppression; however, recovery from the primary kidney malignancy did not exclude the risk of developing a new type of neoplasm in either group.