BACKGROUND Renal transplantation has gained much wider acceptance as a treatment option for local patients with end-stage renal failure in the last three decades. However, there are no local reports regarding the associated urological complications and their management. This paper aims to explore these complications in the local setting. METHODS This is a retrospective review of 440 consecutive renal transplantations performed in Singapore General Hospital over a ten-year period. From the retrieved clinical records of transplant recipients, the occurrence of various urological complications and their management were studied. RESULTS The overall incidence of urological complications among transplant recipients was 7.7 percent. Urological complications included urinary leakage, ureteric strictures, symptomatic lymphocoeles, malignancies, urolithiasis, double-J stent fragmentation as well as haemorrhagic cystitis, and their incidences were 1.4 percent, 2.0 percent, 1.8 percent, 2.3 percent, 0.2 percent, 0.2 percent and 0.2 percent, respectively. Among the malignancies, 70 percent were renal cell carcinomas in the native kidneys. CONCLUSIONS The incidence of urological complications in our series was comparable to those in the various major centres. However, there was a significantly higher incidence of native renal cell carcinoma in our series, which was likely to be secondary to the prolonged period of dialysis prior to renal transplantation.