Long-term survival after successful transplantation is limited by cardiovascular disease. We studied changes in arterial function in children after renal transplantation. We measured pulse-wave velocity (PWV) and the augmentation index (AIX) as estimated from central pulse-wave analysis in 36 patients with a functioning kidney transplant (mean age 14 ± 3.4 years) and 49 healthy children (mean age 13.3 ± 3.3 years). Transplantation had been performed 4.3 ± 3.3 years prior to examination. Transplanted patients had a significantly higher mean PWV of 5.43 ± 0.9 m/s; controls 4.68 ± 0.7 m/s. Likewise, the AIX was significantly higher in patients (-14.3 ± 15.2) than in controls -26.3 ± 13.5. We found no significant associations with the degree of transplant dysfunction, glomerular filtration rate (GFR) loss, or dose of immunosuppressive medications; however, the AIX was associated with the serum calcium-phosphorus product, and PWV correlated with systolic blood pressure and age. This study suggests that subclinical arteriopathy is present in young transplant recipients.