•Introduction: Living donor kidney transplants with multiple arteries was thought to be associated with an increased risk of complications.•Aim of the work: The aim of this study was to evaluate the outcome and the incidence of surgical complications in grafts with multiple arteries.•Patients and methods: This is a retrospective and prospective study that included 22 cases of renal transplantation with multiple vessels graft In this study we aim to evaluate the outcome and complications of multiple vessel graft used in renal transplantation.•Results: Total 22 kidney transplants with multiple vessel grafts were performed. The cases included 14 males and 8 females. Graft perfusion was evaluated using Doppler Ultrasonography in all patients and revealed that 20 cases had a well perfused kidney; one case had a large hematoma immediately postoperatively that necessitated reanastomosis, another case had infarction of the upper pole. Six patients had asymptomatic lymphoceles that required no surgical treatment. Although the incidence of lymphocele is higher if compared to those of single vessel graft but they can be used successfully in renal transplantation without effect on the graft survival.•Conclusion: In the absence of a suitable single vessel graft multiple vessel grafts are a feasible alternative.