A patient with scleroderma and severe renal failure was initially treated with hemodialysis and minoxidil (Loniten) without any improvement in her skin involvement. At a later date bilateral nephrectomy and a successful cadaveric renal transplant were performed. Her cutaneous manifestations have improved remarkably during the four years since transplantation. Because these patients do not tolerate hemodialysis very well, renal transplantation appears to be the most effective form of treatment, with the possible added benefit of cutaneous improvement.