Abstract: Objective To evaluate the clinical characteristics and the outcomes of primary lung cancer in renal recipients. Methods Between January, 1988 and April, 2015, a total of 2793 consecutive patients underwent renal transplantation at our center. Fourteen (0.5%) patients subsequently developed lung cancer, for which 10 (71.4%) received surgical treatment. Results The mean age of the 14 patients with post-transplant lung cancer was 50.2±8.3 years at transplantation, and 10 of them (71.4%) were former smokers. In 9 (64.3% ) of 14 patients, the malignancies were detected incidentally and 5 patients were symptomatic. The average interval from transplantation to cancer diagnosis was 65.7±20.1 months. Eleven patients died from cancer metastasis or organ failure and 3 remained alive with functioning graft. The survival rates of the patients with lung cancer in different stages were statistically different (P=0.001). The overall 5-year survival rate after diagnosis was 17.9% in these 14 patients. Conclusion The risk of primary lung cancer might be higher in renal transplant recipients than in the general Chinese population. Routine chest screening for lung cancer in renal transplant recipients may help in early detection and treatment of the malignancy to improve the prognosis.