We examined the medical records of renal transplantation patients at our institution to determine the incidence and etiology of renal calculi after renal transplantation. Of 7 patients identified calculi formed on the basis of congenital hyperoxaluria in 2, secondary to chronic urinary infection in 1 and from iatrogenic causes in 4. We review the various surgical and radiological procedures used to treat these renal transplant patients. We also discuss the role of the new treatment modalities in managing urolithiasis in transplant recipients.