Background <p>People with lived and living experience (PWLLE) of kidney failure have significantly high rates of surgery and postoperative complications. Despite these risks, there is lack of consensus on the most important postoperative outcomes for clinical care and research focused on this population. This study aimed to identify and compare the postoperative outcome priorities of PWLLE with those of clinicians/researchers.</p> Methods <p>We recruited PWLLE of kidney failure, clinicians and researchers from across Canada to complete a modified Delphi survey over three rounds between April and June 2024. Participants ranked 100 perioperative outcomes derived from literature, participant suggestions, and expert recommendations. Outcomes were evaluated for consensus using a 9-point Likert scale with predefined consensus criteria. Items not meeting consensus were either dropped or reconsidered in subsequent rounds. Median rankings of prioritized topics were compared between participant groups.</p> Results <p>Of 116 initial respondents, 91 consented to participate, with 64 (70%) completing all three rounds. Participants included 52 clinicians/researchers and 39 PWLLE. The top five prioritized postoperative outcomes were postoperative death within 30 days, intraoperative death, postoperative kidney allograft loss, septic shock, and 1-year postoperative mortality. Cardiovascular complications, dialysis dependency in individuals not requiring dialysis preoperatively, and risk of sepsis were also highly ranked. No significant differences were found in the top 10 priorities across participant groups (<i>p</i> &gt; 0.05).</p> Conclusion <p>We identified key postoperative outcomes for people with kidney failure undergoing surgery. This work will inform future research on perioperative care and the development of postoperative risk prediction tools for PWLLE of kidney failure.</p> Clinical trial number <p>Not applicable.</p>