Introduction: Renal transplantation is not contraindicated in end-stage renal disease developing as a result of complication of overactive bladder with uninhibited detrusor contractions. As an amendatory surgical approach, augmentation ileo-cystoplasty is the preferred option to achieve a low intravesical storage pressure. However, the timing of the augmentation ileo-cystoplasty in combination with renal transplantation is still controversial. Technical Considerations: We analyzed data from 3 of the 1100 renal transplantation patients treated at the Akdeniz University Transplantation Center in whom concomitant augmentation ileo-cystoplasty and renal transplantation were performed owing to hypocompliant bladder. Conclusions: The operation times were 360, 270, and 240 minutes. No perioperative major complication or rejection was detected. Bladder augmentation using ileum patch can be concomitantly performed with renal transplantation safely, and this approach avoids the requirement for a second operation in another session. © 2007 Elsevier Inc. All rights reserved.