Introduction and objective: Renal transplant has evolved as the treatment of choice for end stage renal disease. Accumulated expertise and experience coupled with refined surgical techniques have resulted in excellent patient and graft survival. Despite improvements in surgical techniques, vascular complexities and thus vascular complications resulting out of it are probably the most dreaded , dramatic and have fatal outcome either to the graft or the patient. We present our experience and analysis of the outcome of vascular complexities and its related vascular complications in a series of 6947 cases over a period of 14 years.
Materials and methods: 6947 cases of renal transplants were prospectively evaluated for vascular complexities and subsequent complications.  
Results: The age of patients ranged from 8 years to 72 years with the mean age being 46.5 year.
1769 were open donor nephrectomies while 5176 were laparoscopic donor nephrectomies and 2 were robotic donor nephrectomies. (19.425%) 1349 kidneys had multiple renal arteries which was further sub divided into 1225 having 2 renal arteries, 115 had 3 renal arteries, and 9 had 4 renal arteries. 
Vascular complication were found in 121 patients which included renal artery thrombosis (7 ) patients, renal vein thrombosis (2), renal artery stenosis (11), bleeding from renal vessels necessitating re exploration (97) patients and renal artery aneurysm in 4 patients.
Conclusion: vascular complexity entailing multiple vessels signals increase increase in vascular complications, but improved surgical technique coupled with early diagnosis and subsequent management could avoid graft loss and thereby have a successful outcome.

Key words: Renal transplant, vascular complexity, renal artery stenosis, renal vein thrombosis, renal artery aneurysm.