Background There are limited contemporary data on the epidemiology and outcomes of bacteremia in solid organ transplant recipients (SOTr). Methods Using the Swiss Transplant Cohort Study registry from 2008 to 2019 we performed a retrospective nested multi-center cohort study to describe the epidemiology of bacteremia in SOTr during the first-year post-transplant. Results Of 4383 patients, 415 (9.5%) with 557 bacteremia due to 627 pathogens were identified. One-year-incidence was 9.5%, 12.8%, 11.4%, 9.8%, 8.3%, and 5.9% for all, heart, liver, lung, kidney, and kidney-pancreas SOTr, respectively (P = 0.003). Incidence decreased during the study period (HR: 0.66, P < 0.001). One-year-incidence due to Gram-negative bacilli (GNB), Gram-positive cocci (GPC), and Gram-positive bacilli (GPB) was 5.62%, 2.81%, and 0.23%, respectively. Seven (of 28, 25%) S. aureus isolates were methicillin-resistant, 2/67 (3%) enterococci were vancomycin-resistant and 32/250 (12.8%) GNB produced extended-spectrum beta-lactamases. Risk factors for bacteremia within one-year post-transplant included age, diabetes, cardiopulmonary diseases, surgical/medical post-transplant complications, rejection and fungal infections. Predictors for bacteremia during the first 30-days post-transplant included surgical post-transplant complications, rejection, deceased donor, liver and lung transplantation. Transplantation in 2014-2019, CMV donor-negative/recipient-negative serology, and cotrimoxazole Pneumocystis-prophylaxis were protective against bacteremia. Thirty-day mortality in SOTr with bacteremia was 3% and did not differ by SOT type. Conclusions Almost 1/10 SOTr may develop bacteremia during the first year post-transplant associated with low mortality. Lower bacteremia rates were observed since 2014 and in patients receiving cotrimoxazole prophylaxis. Variabilities in incidence, timing, and pathogen of bacteremia across different SOT types may be used to tailor prophylactic and clinical approaches.