OBJECTIVES:  Post-transplant expectations can be overwhelming.  We assessed the relationship between health literacy and unmet immunosuppressant (IS) drug information needs in kidney transplant recipients. We hypothesized that patients with low health literacy have greater unmet IS drug information needs compared to patients with optimal health literacy.   METHODS: A cross-sectional survey was mailed out to 300 kidney transplant patients recruited from a single urban transplant center. Inclusion criteria were receiving post-transplant care at the center and receiving the transplant 1 to 36 months before inception of the survey. A validated scale measured functional, communicative and critical health literacy. An unmet IS drug information need was defined as a person reporting some to a significant problem and too little information on areas related to IS drug management.  A person with 7 or more unmet IS drug information needs was categorized as having high unmet IS drug information needs. Logistic regression was used to produce unadjusted and adjusted OR controlling for age, race, gender, and time since transplant. RESULTS: A response rate of 50% was obtained. 61.3% of respondents were male and the mean age was 56.7 (+/- 11.2) years. Cronbach’s alphas for functional, communicative, and critical health literacy respectively were 0.87, 0.88 and 0.83. Patients with high functional health literacy (ORunadjusted: 0.23 [0.07, 0.82]; ORadjusted: 0.26 [0.06, 1.09]) and patients using the transplant staff as a source of information about transplant medications (ORunadjusted: 0.43 [0.19, 0.94];  ORadjusted: 0.28 [0.10, 0.78]) were less likely to report high unmet IS drug information needs. CONCLUSIONS: Patients with low functional health literacy have high unmet IS drug information needs, which might affect the management of their condition. It is important to assess patients’ health literacy, tailor communication and materials accordingly, and regularly reinforce IS issues in order to meet their IS drug information needs.