Abstract: Objective To explore the diagnosis and treatment of urinary obstruction involving the transplanted kidney. Methods A retrospective analysis was performed in 16 cases of urinary obstruction involving the transplanted kidney, including 5 cases of ureteral calculi, 6 vesicoureteral anastomotic stricture, 2 pyeloureteral junction stricture after transplantation, 1 ureter necrosis due to graft rejection, and 2 infection surrounding the renal graft and ureter end necrosis. Results Only one patient had the renal graft removed due to massive hemorrhage in an open surgery for correction of urinary obstruction, and the renal function of the graft was preserved in all the other cases after endoscopic or open surgeries. In the follow-up for 0.5 to 3 years after the second surgery, serum creatinine of the patients were maintained within the range of 90-150 μmol/L, without further renal enlargement or exacerbation of renal retention shown by B-mode ultrasonography. Conclusions Urinary obstruction after renal transplantation is a difficult surgical complication, which can be managed by endoscopic or open surgeries depending on the causes of the obstruction.