OBJECTIVES: Although kidney transplantation improves health-related quality of life (HRQoL) and survival in end-stage renal disease, the HRQoL domains that are particularly affected and the factors which influence future HRQoL are unclear. A systematic review was undertaken to identify these factors in a European population. METHODS: Medline, EMBASE, Medline In-Process and the Cochrane Library were searched for relevant studies describing the impact of renal transplantation on work performance, social interaction/family life, psychological function or HRQoL. Publications from UK, France, Spain, Italy, Germany, Belgium, Netherlands, Sweden, Denmark, Norway and Finland reporting outcomes for 2005-2015 in English were reviewed and their findings reported. RESULTS: Forty-one articles met the inclusion criteria. The -Item Short Form Survey (SF-36) was the most frequently used patient-reported outcome (PRO) tool to measure HRQoL (in 24 studies). The End-Stage Renal Disease Symptom Checklist – Transplantation Module and the Renal Transplant Recipients Quality of Life (QoL) questionnaire were the most frequently used disease-specific questionnaires to measure HRQoL. Post-transplantation HRQoL was generally improved compared with pre-transplantation on both disease specific and generic scales. Transplant patients with higher creatinine clearance ~60 mL/min scored higher among 7 SF-36 health dimensions than those with creatinine clearance below 60 mL/min. Donor status was a predictor of HRQoL; apart from bodily pain, other scores were significantly better in patients who received a living donor-kidney.  Demographic factors having an influence on HRQoL included gender, age and employment. In addition, comorbid conditions and treatment side effects had a large impact. The type of immunosuppressant therapy also affected HRQoL, with those receiving tacrolimus showing improved HRQoL compared with patients on ciclosporin. CONCLUSIONS: The current review offers insights into the impact of renal transplantation on HRQoL. Following transplantation, patients with higher renal function and those receiving an organ from a living donor showed higher HRQoL than other transplant recipients.