Renal transplantation has revolutionized treatment of end stage renal disease with improved quality of life of patients. Despite technological advances, transplants are prone to numerous complications. Ultrasound is uniquely placed as an imaging modality in such situations since it is not associated with nephrotoxic contrast usage or with ionizing radiation. It quickly helps to identify treatable complications and also to decide further management or plan a biopsy. This study was a prospective study where 30 consecutive patients who underwent renal transplant were followed up with ultrasound and associated complications were analysed. Acute rejection was noted to be the commonest early complication (33%) and renal artery stenosis and chronic rejection (13%) were the commonest late complications. Ultrasound and Color Doppler were found to be useful in detection of vascular and urological complications but were noted to be of limited value in assessing parenchymal complications causing graft dysfunction.