The prevalence of obesity is increasing in the renal transplant population. There are controversial data with respect to posttransplant outcome. We performed a study comparing the incidence of surgical and infectious complications among 40 obese patients (body mass index [BMI] pretransplant greater than or equal to30 kg/m(2)) versus a matched nonobese control group (BMI <30 kg/m(2)) transplanted at our center between June 1989 and March 2001. Results: There were no differences in patient demographic variables (mean age, gender, cause of renal failure, or percentage of diabetes or hepatitis C virus infection). Donor age, HLA mismatching, sensitization, cold ischemia time, and immunosuppressive regimen were similar in both groups. The mean pretransplant BMI in obese and nonobese patients was 34.1 +/- 4.0 versus 23.00 +/- 2.73 kg/m(2) (p < .01). The obese group showed a higher incidence of delayed graft function (30% versus 5%, P < .05) and wound infections (12.5%) posttransplant with similar incidences of wound dehiscence, perigraft collections, and graft function at the end of follow up.