Parenthood in renal allograft recipients is no longer rare. Rational guidelines are needed since there are no absolute medical contraindications to parenthood in recipients of either sex. This report by the patient and her physician describes the clinical course of the recipient of a cadaveric renal allograft, including a normal pregnancy and delivery. Urine protein excretion increased during pregnancy, but later returned to normal. There were no complications to mother or fetus, despite continued immunosuppressive therapy. The problems of parenthood in allograft recipients are discussed from the patient viewpoint, rational guidelines for patient counseling are offered, and the world's literature is reviewed. The possible complications to parent and fetus are discussed, including the complications of pregnancy and immunosuppressive drug therapy. We conclude that parenthood should be the choice of the allograft recipient.