Acute pancreatitis occurred in 7 patients 3 days to 8 years after renal transplantation. Three patients had or developed biliary calculi which may have been responsible for the disease and 3 patients had cytomegalovirus infections with rising antibody titres. Two patients had more than 1 attack, 1 patient died and 1 patient, during an episode of acute pancreatitis, suffered rejection of the renal allograft which had to be removed. Aetiology, management and the place of surgery are discussed with reference to 1 patient, in whom interventional radiology successfully avoided the need for further surgery.