There are only case reports published on cryocrystalgloublinemia, as it is a rare disorder characterized by immunoglobulin assembly into crystalline arrays with associated thrombosis, ischemia and infarction leading to multi-organ failure. We present a case of a 76-year-old male with end stage renal disease secondary to bilateral renal artery occlusion as a thrombotic manifestation of cryocrystalgloublinemia who underwent renal transplantation in 2009. The patient presented with levido reticularis, digitial ischemia, heart failure and acute kidney injury in 2023 with recurrent cryocrystalgobulinemia diagnosed on renal allograft biopsy. The patient also had coincident recurrent IgG kappa paraproteinemia, which had previously resolved following a bone marrow transplant conducted in 2008 prior to his kidney transplant. For treatment of the recurrent cryocrystalglobulinemia post-transplant, the patient received plasmapheresis and pulse methylprednisolone therapy with no improvement in his clinical manifestations. He ultimately passed away from complications of his disease prior to initiation of any further immunosuppressive therapy. To our knowledge, this is the first reported case of recurrent cryocrystalglobulinemia following renal transplantation.