Kidney transplant is the best treatment for adult and pediatric end-stage renal disease (ESRD). Minimally invasive surgery has become the gold standard for live donor nephrectomy since its introduction (mainly laparoscopic surgery). Living donation shows better results in terms of patient and graft survival in comparison to cadaveric donor nephrectomy; however, currently, most of the grafts implanted come from deceased donors. In contrast with the donor nephrectomy development, the open approach is still nowadays the preferred access for transplantation technique with slight modifications considering its excellent results. The objective of this chapter is to describe all the renal transplantation procedures and define the most important steps of them.