Background <p>Kidney transplant recipients are reported to have more opportunities for employment compared with patients on hemodialysis. However, comparisons of employment and lifestyle situations between kidney transplant recipients and patients on hemodialysis in Japan are lacking.</p> Methods <p>This cross-sectional study was conducted via a questionnaire survey in October and November 2023. The questionnaire covered patients’ background, hospital visits, self-management, social assistance, and employment. Participants were members of the Japan Transplant Recipients Organization. We compared these participants with data from a survey of patients on hemodialysis conducted in September 2021 by the Japan Association of Dialysis Physicians.</p> Results <p>Responses from 146 kidney transplant recipients were analyzed and compared with data for 7461 patients on hemodialysis. The overall employment rate for kidney transplant recipients was 41.0%, and was higher than that among patients on hemodialysis. Of the employed kidney transplant recipients, 67.8% worked at least 5&#xa0;days per week, 45.8% had an annual income of more than 3 million yen, and 42.4% were in regular employment. The majority (78.7%) of kidney transplant recipients could visit hospital by themselves, with this proportion significantly higher than that among patients on hemodialysis. Substantially fewer kidney transplant recipients had been briefed by their hospital on disaster preparedness than patients on hemodialysis (20.4% vs. 53.2%).</p> Conclusions <p>We evaluated current employment status among kidney transplant recipients in Japan through a questionnaire survey. Compatibility with work among kidney transplant recipients was relatively favorable compared with that among those on hemodialysis.</p>