AIMS OF THE STUDY: To evaluate the outcome of kidney transplantation in children with low weight. METHODS: Retrospective review of the medical records of patients weighing 11 kg or less that received kidney transplantation between 2001 and 2013 were retrospectively reviewed. RESULTS: Fifty-nine kidney transplantations were performed in pediatric patients in our center, 12 of them were performed in patients weighing 11 kg or less (20%). The mean age of the recipient at the time of transplantation was 2 years (1-3.5); the mean weight was 9.4 ± 1.1 kg (8.3-11). The etiology of kidney failure was malformative in 42% of patients, inherited in 33%, glomerular in 8% and oiler etiologies in 17% of the patients. Two patients did not receive replacement therapy before transplantation (16.7%), nine received peritoneal dialysis (75%) and one of them hemodialysis (8.3%). Eleven of the grafts were from cadaveric donor (91.7%) and one of them from a living donor (8.3%). The mean donor age was 10 years (0.5-29). There was one case of acute graft thrombosis (8.3%) and one case of eventration requiring reoperation; there were no other major complications. Mean follow-up was 59 months (4-130). Overall survival (OS) was 100% at 1 year and 91.7% at 5 years. There was one death in a patient with mitochondrial disease with a functioning graft. Graft survival (GS) was 92% at 1 year and 75% at 5 years. CONCLUSION: Kidney transplantation is the treatment of choice for end-stage kidney failure in the young child. It provides good results in terms of patient and graft survival.