Post-transplant de novo glomerulonephritis (GN) often presents with clinical and histologic features like primary or secondary GN seen in native kidneys. However, in the transplanted kidney, these glomerular lesions are frequently complicated by preexisting structural changes or additional injury from antibody- or cell-mediated rejection, immunosuppressive medications, and superimposed infections. This overlap can make diagnosis challenging, as vascular, glomerular, and tubulointerstitial alterations coexist. The pathophysiology of de novo glomerular diseases is diverse, reflecting the complex interplay between alloimmune responses, drug toxicity, infections, and intrinsic glomerular injury in the transplant setting.