Objectives: The aim of this study was to screen transplant patients for the presence of inflammatory and atypical cytological changes, and to correlate cytological finding with demographical, clinical data and type of immunosuppressive drug in use. Methods: A total of 300 voided urine samples were collected from patients , 242 males and 58 female, there ages were ranged from 11 to 71 and mean age 41years. All patients were using immunosuppressive drugs including cyclosporine, Tacrolimus, mycophenolate motifel, with highest ratio of patient taking tacrolimus (38.6%), and the least were taken cyclosporine (13%). The average period of transplant was 8.4 years, with the highest group (64.3%) were 0 â€“ 4.2years. Results: 300 cases were identified, including 262(87.34%) reported with normal cytology, the remainder 38(12.6%) were inflammatory, in which 6(2%) have a nonspecific inflammation, 17(5.67) consist from viral infections that includes (3 BKV, 2 CMV and 12 HPV), 10(3.34%) Bacterial infections, 3(1%) fungal infections constitute from candida albicans and 2 were mixed of bacterial and fungal infections. Conclusion: The study concluded that urine cytology is an excellent tool for routine follow up of renal transplant recipients to detect a variety of inflammatory and infectious agents, and need to be a widely recognized among physicians.