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Studies to prevent organ rejection in renal transplant patients are continuing. Improvement in HLA-matching and efficiency of immunosuppressive drugs are the most important factors. In this study, effects of single or three consecutive high dose (pulse) methylprednisolone therapy on acute rejection frequency in renal transplant recipients were investigated. Total of 30 patients were included in the study. There were 18 patients in the first group (10 M, 8 F, mean age 29.6±6.5) and single dose of 15 mg/kg methylprednisolone iv was given during the renal transplantation operation to these patients. The second group included 12 patients (8M, 4 F, mean age 31.2±7.9) and 15 mg/kg methylprednisolone iv was given during the renal transplantation operation and the same daily dose repeated next two days. Following high dose iv methylprednisolone treatment, prednisolone administration switched to oral route and dose reduced from 2.5-3 mg/kg to 20 mg/day in all patients in ten days. Other immunosuppressive drugs were cyclosporin-A (8 mg/kg bid) and 2.5-3 mg/kg azathioprine in all patients. Two groups were compared for delayed graft function, acute rejection episode, acute tubular necrosis and infection frequency which developed during the post transplant 6 months follow up period. There were no statistically important difference for delayed graft function, acute tubular necrosis and infection between two groups. However frequency of acute rejection attack was higher in the first group ( 44% versus 8%, p<0.05). Our results suggest that, use of three days high dose i.v. methyl prednisolone may be an alternative to decreases acute rejection frequency in renal transplant recipients.