*Purpose: The expanding supply-demand mismatch between organs available for transplantation and patients in need led to the growth of transplant tourism. In our study, we compare the outcomes of renal transplant tourism with local transplants done in our center.

*Methods: A single-center retrospective cohort study comparing patients who underwent transplant tourism to patients who underwent transplant locally at our institution.

We included all patients who underwent renal transplant and were followed up in our institution for at least one year post transplant between January 2015 and December 2018. We excluded patients who did not complete 1 year follow up in our hospital, patients younger than 14 years old and patients who presented to another local hospital first before following with us. Data was collected from the patients’ electronic medical records.

*Results: A total of 314 kidney recipients were included in this study. 254 patients had kidney transplants at our center and 60 patients received kidney transplants abroad. Almost all transplant tourism recipients (tourists) received a kidney from a living donor (98.2%) whereas the living donors were (76.1%) in the local group. More than half of the transplant tourism group lacked the induction information. Surgical details, donor data and discharge summaries were available for the minority of the transplant tourism group.The overall one-year graft and patient survivals are almost similar in both groups but at three-years follow up there was more graft failure in the transplant tourism recipients (11.7% vs 0.8%, P<0.001). Delayed graft function (DGF) rate was significantly higher among transplant tourists (18.3% vs 6.3%, P; 0.005). The Acute rejection rate was significantly higher within the first year in the transplant tourism group compared with the local group (40% vs 7.9%, P<0.001). Serum creatinine at one week, one, six and twelve months was significantly lower in the local group (<0.001).

*Conclusions: Transplant tourism was associated with an overall worse post-transplantation course including higher rates of acute rejection, poor graft survival and increased severity of infectious complications.

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