Renal homotransplantation has been performed in 19 children with terminal, irreversible, renal disease. Techniques used in adults for preoperative and operative management have been successfully modified. There have been no technical problems related to ureterovesical and vascular anastomoses. Rejection episodes were mild and when recognized and appropriately treated early were easily reversed. Normal growth patterns of children are altered by the presence of renal disease and during periods of heavy steroid administration. However, favorable growth curves have been noted in all children under 15 years of age in long-term follow-up. The overall recipient and transplant survival was 94.7%. The general overall results with renal homotransplantation in children and particularly the low incidence of late problems have been encouraging.