Background: Precise diagnosis of renal transplant complications is very important as many complications are potentially treatable if detected early. CT, MR imaging, and nuclear medicine studies play a complimentary role. Nuclear medicine renal scans (using radioactive 99mTc DTPA or 51Cr-EDTA) are considered the gold standard for the evaluation of kidney function because of their accuracy Objective: To spotlight on the important role of nuclear medicine on the preparation of both donor and recipient, follow up and early detection of any abnormality in the transplanted kidney with smooth noninvasive techniques. Conclusion: Renal scintigraphy (RS) has its merits for the evaluation of complications after kidney transplantation, especially for urological and/or vascular complications. Early diagnosis of vascular and urological complications can contribute to a more specific surgical intervention and better post-transplant outcomes. RS should be used in case of non-acute complications, and if the ultrasound (US) provides insufficient results. Radionuclide imaging has the unique advantage of relating perfusion to function. Comparative studies between renal scintigraphy and Doppler sonography seem to have similar performance in the evaluation of renal transplant perfusion.