OBJECTIVES: The aim was to study the changes in the HRQOL during the first year following renal transplant. METHODS: A total of 508 patients from fifteen transplant centres in Spain were included in a kidney waiting list and 200 were prospectively studied. QoL over time (before, at three and six months after transplantation) was obtained using the SF-36 and the End-Stage Renal Disease Symptom Checklist (ESRD-scl). Clinical and socio-demographic records were searched. RESULTS: Some clinical variables (haemoglobin and serum creatinine) improved 3 months after transplantation. Comparison the SF-36 dimensions before and three months after transplantation, all domains, as well as physical (PCS) and mental component summaries (MCS) (p<0.01), showed significant improvement except in Bodily Pain and Physical Functioning. Comparison of SF-36 between three and six months after transplantation, only role-physical showed significant improvement and the rest of physical dimensions showed similar scores, but mental functioning was a little worse than at three months post transplant. For ESRD-scl before and three months after transplantation, the symptoms were better (Limited Physical Capacity, Limited Cognitive Capacity, Cardiac and Renal Dysfunction and Transplantation-associated Psychological Distress, except for Increased Growth of Gum and Hair) (p<0.01). Comparing three and six months post-tx, only Side Effects of Corticosteroids dimension showed significant improvement. Females significantly more often showed the worst HRQoL (MCS, Vitality, Mental Health and Role-emotional; p <0.001). Age, educational level, dialysis modality before transplantation, time on dialysis and comorbidity index did not affect the HRQoL after transplantation. However, variables that were not significant in the overall score reached significance in some symptoms. CONCLUSIONS: The most important finding in this study is that all domains showed a significant improvement in HRQoL three months after transplantation, and at six months HRQoL was slightly improved, while mental domains remained the same with respect to measurements at three months.