Objective To compare complications of ureteroneocystostomy and end-to-end ureteroureterostomy after kidney transplantation. Methods Eighty allograft renal transplantation patients between January 2005 and October 2008 were divided into two groups according to urinary tract reconstruction approach: ureteroneocystostomy group (40 cases) and ureteroureterostomy group (40 cases). Complications including leakage of urine,vesicoureteral reflux,obstruction of ureter and urinary tract infection were recorded.Results In ureteroneocystostomy group and ureteroureterostomy group,the patients were followed up for 13 - 46 (24.5 ± 8.9), 13 - 46 (26.0 ± 7.2) months postoperatively, urinary complications were recorded for 10 eases (25.0%, 10/40) and 4 cases (10.0%, 4/40)(P > 0.05), incidence of leakage of urine were 2.5%(1/40)and 5.0%(2/40) (P > 0.05), vesicoureteral reflux were 10.0% (4/40) and 0 (P ＜ 0.05), obstruction of ureter were 0 and 5.0% (2/40) (P > 0.05), and urinary tract infection were 12.5% (5/40) and 0 (P < 0.05).Conclusions Compared with ureteroneoc ystostomy, ureteroureterostomy can reduce the incidence of vesicoureteral reflux and urinary tract infection,it can be regarded as the first choice for urinary tract reconstruction after kidney transplant recipients.