OBJECTIVE Solitary pancreas or combined kidney-pancreas transplantation is currently the only therapeutic procedure for complete resolution of diabetes mellitus type I. The aim of the present study is to investigate the role of multislice computed tomography (MSCT) in the follow-up of patients subjected to solitary pancreas or combined kidney-pancreas transplantation. METHODS Sixteen patients who had undergone solitary pancreas (n=8) or combined kidney-pancreas (n=8) transplantation, with systemic-bladder (n=6) or portal-enteric (n=10) pancreatic drainage were evaluated with MSCT (Light Speed Plus, GE Medical System). In solitary pancreas follow-up the MSCT study included arterial and portal phases; in combined kidney-pancreas transplanted patients the urographic phase was included. The acquisition was performed with 1.25 mm collimation, 0.6 mm reconstruction interval and a pitch of 6. An MSCT scan of the thorax was included in patients suspected of having lung complications. RESULTS In all cases MSCT allowed identification of the surgical technique performed, evaluation of the transplanted pancreas, and assessment of complications, if present. The following major complications were identified: thrombosis or stenosis of the arterial graft, pancreatic infarction, ectasia of the common iliac artery and arterial graft, dehiscence of the duodenocystostomy, infected abdominal collections, pulmonary infections. CONCLUSIONS MSCT is able to detect complications arising in the transplanted organs and those related to immunosuppressive therapy, and confirms its usefulness in the follow-up of solitary pancreas or combined kidney-pancreas transplanted patients.