Four surgical techniques for living donor nephrectomy were analyzed retrospectively in terms of perioperative outcome and early complication rate. A total of 182 donor nephrectomies including 69 open (OLDN), 14 fully laparoscopic (LDN), 34 hand-assisted laparoscopic (HLDN) and 65 retroperitoneoscopic (RLDN) nephrectomies were analyzed. There was a significant difference in mean operating time (OPT) between the OLDN (160 min) and RLDN (150 min) as compared to the LDN (212 min) and HLDN group (192 min) (P < 0.001). Mean warm ischemia time (WIT) was significantly shorter with OLDN (114 s), RLDN (121 s) and HLDN (128 s) when compared to LDN (238 s) (P < 0.001). Major complication rate was comparable among the groups. Independent of the preferred technique, donor nephrectomy is associated with complication rates. RLDN is comparable to OLDN in terms of OPT, WIT. Learning endoscopic donor nephrectomy could be associated with a higher complication rate.