Our aim was to evaluate cardiovascular risk profile in 42 children with kidney transplants (KT) at the Queen Silvia Children's Hospital, Gothenburg Sweden.Forty-two children (7.1-18 years) with KT, time from transplantation 3.5 (0.9-13) years, were examined at inclusion and annually for three consecutive years. Eighteen matched controls were examined once. Cardiovascular phenotyping included ultra-high frequency ultrasound (UHFUS), pulse wave velocity (PWV) and endothelial function.Children with KT had higher body mass index (BMI) z-score and blood pressure (BP) z-score than healthy controls (BMI z-score: 0.4 ±1.0 and -0.2 ± 0.9, respectively, p=0.02; SBP z-score: 0.5 ± 0.9 and -0.8 ± 0.7; DBP z-score: 0.7 ± 0.7 and -0.3 ± 0.5, respectively, p0.001). BP z-score decreased significantly over three years, other vascular markers remained unchanged. PWV and Carotid intima thickness (IT) was higher in children with KT compared to healthy controls. Children with preemptive KT had lower radial IT and dorsal pedal media thickness (MT) compared to children with preceding dialysis.Children with KT show increased cardiovascular risk parameters, not increasing over time. Children on dialysis before KT have more pronounced vascular changes than those with preemptive KT, suggesting preemptive transplantation more beneficial for cardiovascular health.