A 41-year-old man was referred to our department for surgical treatment for aortic stenosis 7 years after renal transplantation. He had been diagnosed with aortic stenosis by echocardiography a year before. He had syncopal attack during exercise 2 months before and surgical treatment had been indicated. We successfully performed aortic valve replacement via right mini-thoracotomy in the 4th intercostal space. Cardiac surgery after renal transplantation is rare and many complications may happen. Minimally invasive cardiac surgery is considerated to be useful in minimizing mediastinitis in patients on immune suppressants.