Renal transplant patients may be afflicted by a wide spectrum of musculoskeletal complications, often arising from the interaction of preexistent renal osteodystrophy and adverse effects of posttransplant medications. In this review I discuss the most commonly encountered problems, emphasizing the clinical manifestation and treatment. Abnormalities of mineral metabolism include hypercalcemia, hypophosphoremia, and hypomagnesemia. Loss of normal skeletal function may lead to osteopenia, osteonecrosis, growth retardation and bone deformities. The most frequent joint problems are gout, arthralgias, rupture of extensor tendons and persistent β-2 microglobulin amyloidosis. Patients maintained on cyclosporine may develop dental complications, especially gingival hyperplasia. Unfortunately, these musculoskeletal problems limit the rehabilitation of some patients after successful renal transplantation.