BACKGROUND En-bloc kidney transplantation from a small pediatric donor to an adult recipient has become more common owing to the shortage of deceased donor kidneys. In pediatric en-bloc kidney transplantation, ureterovesical anastomosis can be done either via ureteroneocystostomy or via partial bladder wall transplantation. We report 2 cases of en bloc kidney transplantation from a pediatric deceased donor to an adult recipient using different ureterovesical anastomosis methods and the long-term outcomes. CASE REPORT Two pediatric en-bloc kidney transplantations to adult recipients were performed at our center. One case used a graft bladder segment from a 5-month-old male donor that was transplanted to a 45-year-old adult male recipient using the bladder patch technique and one case used 4-year-old male donor kidneys transplanted to a 54-year-old adult male recipient via ureteroneocystostomy with ureteroplasty for ureterovesical anastomosis. Both recipients have shown normal renal function and normal voiding, without urinary complications, such as vesico-ureteral reflux and ureter stricture, during the follow-up period. CONCLUSIONS These 2 case reports suggest that using small pediatric en-bloc kidneys would be a viable option to overcome the increasing shortage of donor kidneys for transplantation regardless of the method of ureterovesical anastomosis.