Kidney transplantation is the treatment of choice for most patients with end-stage renal disease (ESRD). Strategies to increase donor organ availability and to prolong the transplanted kidney's survival have become priorities in kidney transplantation. Current success in pediatric renal transplantation is mostly attributed to improvement in immunosuppressive therapy, and the provision of age – appropriate clinical care. This review aimed to evaluate the short and long-term benefits and harms of mammalian target of Rapamycin (mTOR) inhibitors; Sirolimus and Everolimus when used in primary immunosuppressive regimens for kidney transplant recipients.