Aims:Tacrolimus and Cyclosporine A (CyA) are cornerstones in immunosuppressive therapy. Cyclosporine side eff ects include hypertension and hypercholesterolemia both of which may increase the risk of cardiovascular mortality, gingival hyperplasia and hirsutism are known to reduce quality of life. The aim of this prospective study was to evaluate changes in cardiovascular risk profi le and cosmetic side eff ects after conversion from CyA to tacrolimus.Methods: 25 stable kidney transplant recipients (9 male, 16 female) were converted from a CyA to a tacrolimusbased regimen. Mean age was 45.7 ± 13.5 years. Time to switch following transplantation was 4.7±1.7 years. Reasons for conversion were multiple: arterial hypertension (9), hypertrichosis (3), gingival hyperplasia (3), hyperlipidemia (14).Results: 19/25 patients completed the one year study period. One patient died, two returned to hemodialysis, two were switched back to CyA and one patient was lost to follow-up. There were statistically signifi cant changes (p = < 0.05) in systolic and diastolic pressure and antihypertensive medication could be reduced in 13 patients. The dose of lipid-lowering agents could be reduced in the majority of the recipients and a complete withdrawal was achieved in 7 patients. Hypertrichosis and gingival hyperplasia resolved in all patients. Further, there was a signifi cant improvement (p = <0.05) in urea and serum creatinine levels. Adverse events were consistent with the established safety profi le for tacrolimus.Conclusions: Conversion to a tacrolimus-based regimen led to an improvement in the cardiovascular risk profi le. Further, cosmetic side eff ects which may lead to non-compliance, resolved after the switch.