Rationale:Among patients with post-transplant lymphoproliferative disorder (PTLD), there is a high incidence of immunosuppressed transplant recipients. It is necessary to make an early diagnosis to increase the likelihood of a good prognosis.Patient concerns:We report a case of a 54-year-old female patient who developed PTLD after liver and kidney transplantation.Diagnoses:We aimed to analyze the standard diagnosis and follow-up of PTLD with imaging. Radiologists need to be familiar with all imaging modalities when dealing with PTLD, including ultrasonography, computed tomography, magnetic resonance imaging, positron-emission tomography/computed tomography.Interventions:The initial treatment included both reduction of immunosuppression and rituximab. Then the treatment strategy changed to rituximab and chemotherapy. Finally, the treatment strategy combined glucocorticoid therapy.Outcomes:The patient was in a stable condition at the 3-month follow-up.Lessons:Systematic evaluation of the various imaging modalities, treatment options, and prognoses of PTLD in renal allografts suggested that in cases with a poor prognosis, the proper imaging modalities provide essential information with regard to the determination of the appropriate treatment.