Background: Pulmonary hypertension (PHT) is common in patients with end stage renal disease (ESRD). Moderate to severe PHT is a strong independent predictor of mortality in hemodialysis (HD) patients, and in those undergoing noncardiac surgery. The studies which have evaluated the association of PHT with renal transplant outcomes have shown conflicting results. We performed a systematic review and meta-analysis of the current available evidence examining the effect of existing PHT on relevant clinical outcomes following renal transplantation.