Previously reported results of renal transplantation in the older age group have been discouraging; thus this form of therapy has generally been denied to patients over 50 years of age, unless a living related donor was available. A review of our transplant patients aged 51 or older who received cadaver donor kidneys was performed, and comparison was made to the survival being achieved for this group through hemodialysis or transplantation from living related donors. Functional survival of the homograft in the older age group in the Massachusetts General Hospital series compared favorably to that reported by the National Transplant Registry for recipients of all ages. We conclude that cadaver donor transplantation should be offered to increasing numbers of end-stage renal failure patients older than 50 years of age.