Here we report a case of 49 year-old male who has received kidney transplantation twice because of dialysis-dependent chronic renal disease. Transplant nephrectomy was performed after the first transplantation since spontaneous allograft rupture occurred 7 days after transplant. Then the patient got another kidney transplantation

but followed by thrombosis of the left external iliac artery perfusing the allograft. Though the blood perfusion was recovered by endovascular treatment

the function of the allograft was lost forever due to the long-lasting ischemic injury. This case reminds us of the risk of thrombosis of the iliac artery anastomosing with the grafted renal artery

especially when the patient is of high risks of thrombosis

so as to enable timely diagnosis and management

then to achieve a better prognosis.