Patients with severely impaired left ventricular function are known to have a poor prognosis. We describe a 20‐year‐old man with end‐stage renal failure, on dialysis, with severely impaired left ventricular function which dramatically improved after renal transplantation. This suggests that poor left ventricular function need not preclude renal transplantation and may, in fact, offer an alternative to combined renal and cardiac transplantation.