Abstract: Objective To explore the causes of postoperative severe infection in the kidney transplantation and evaluate the prognosis of patients. Methods The clinical and follow up data of 125 kidney transplantation patients in our hospital between September, 2005 and February, 2015 were studied. All patients were given perioperative immune inhibiting intervention; the induction regimen was 20 mg qd basiliximab for injection before the operation and 4 days after the surgery. The postoperative severe infection was observed, and possible etiologic factors were explored and analyzed. The clinical outcome of patients was recorded. Results Among the 125 recipients, 22 were with positive reactive antibody. Thirty-one patients were with severe infection (24.8%), among them, 4 patients died (3.2%). The isolated 35 strains of bacteria from these 31 patients included 7 strains of pseudomonas aeruginosa, 6 strains of Klebsiella pneumoniae, 4 strains of Haemophilus influenzae, 3 strains of Escherichia coli, 3 strains of acinetobacter Baumann/hemolysis, 2 strains of enterobacter cloacae, 2 strains of pseudomonas maltophilia, and 8 strains of staphylococcus epidermidis. Univariate analysis showed that the primary disease, history of cardiopulmonary resuscitation and history of antibiotic of donors, the age of recipient, the number of transplants were related to the postoperative severe infection (P<0.05). Binary Logistic regression analysis showed that the number of transplants and history of antibiotic of donor were the major independent risk factors for the postoperative severe infection (P<0.05). The antibiotics and symptomatic treatment can improve the prognosis of patients. Conclusion The postoperative severe infection in the kidney transplantation is common, the number of transplants and donor history of antibiotic are the main causes for the postoperative severe infection. The effective clinical measures should be taken to prevent and control the infection.