Introduction: cardiovascular disease is a major cause of morbidity and mortality after kidney transplantation. Endothelial dysfunction was shown to constitute an independent predictor of cardiovascular events.Objective: To detect early vascular changes in pediatric renal transplant recipients.Method: 36 pediatric renal transplant recipients at the end of their first post transplantation year, 30 patients with ESRD on regular hemodialysis and 30 normal subjects, were included. Doppler ultrasound was performed for assessment of brachial artery flow mediated dilatation, carotid artery intima media thickness, and renal resistivity indices.Results: Carotid artery IMT measurements in transplantation group (mean ±SD=0.43±0.08mm) were significantly (p=0.001) lower than dialysis group (0.5±0.1mm), and insignificantly (p=0.31) higher than of the control group (0.41± 0.07mm). Renal resistivity indices in control group (mean ±SD=0.61±0.06) was significantly (p=0.026) lower than those of transplantation group (0.64±0.06). The mean (±SD) FMD of transplantation group (12.01±9.52) was significantly (p=0.04) higher than those of dialysis group (7.578±6.78) and insignificantly (p=0.08) lower than that of normal controls (16.13±8.39).Conclusion: Pediatric renal transplant recipients tend to show evidence of vascular dysfunction, although significantly less than those on regular hemodialysis.