This report reviews the features of 149 cases of renal allograft rupture, while adding a detailed description of 3 more cases to the English literature. From November, 1973 to November, 1979, 3 cases of renal allograft rupture occurred in 100 renal transplants performed at Research Medical Center, Kansas City, Mo., an incidence of 3.0%. Rupture developed between the 6th and 8th day after transplantation while patients required dialysis because of poor allograft function. All patients had surgical exploration and successful repair of laceration. Clinical and/or histological findings were consistent with acute rejection in all 3 cases. One graft functioned for 5 years with gradual loss of function. The other two grafts are functioning at the present time. Review of reported cases suggests that acute rejection is the most common cause of allograft rupture. Rupture of the renal allograft did not appear to increase the intensity of rejection, nor did it represent an irreversible rejection. Transplant nephrectomy can be avoided unless hemorrhage is uncontrollable from the site of laceration.