Rh-negative blood types are rare in the Han population in China, and their kidney donors are even rarer. We provided a case of Rh-negative blood type uremic patient with Rh-positive donor for renal transplantation, and the patient is now more than 2 years postoperative with normal renal function, which is reported as follows: The patient is a male, Han Chinese, 37 years old, B blood type, Rh-negative, suffering from chronic renal insufficiency (uremic phase), and the primary disease is chronic glomerulonephritis. The patient underwent allogeneic kidney transplantation in our hospital after six months of regular hemodialysis. The donor was a cadaver kidney, male, 27 years old, with B blood type and Rh positive. The recipient was PRA negative preoperatively, the donor-recipient HLA mismatch was at 4 loci, the lymphocytotoxic cross-test was 2%, the donor kidney was heat-ischemic for 5 min and cold-ischemic for 7 h. The donor kidney was perfused with purine citrate immediately after excision, resulting in a pale donor kidney and no blood in the renal venous outflow. The donor kidney was fully perfused once more before transport to the hospital for kidney repair. The recipient received 0.75g of MMF orally before surgery, and 2000mg of methylprednisolone was administered intravenously during the kidney transplantation, and the doses of methylprednisolone were 1500mg, 1000mg, and 500mg for the first three days after surgery, respectively. On the 10th postoperative day, the patient suddenly developed oliguria, blood pressure increased, blood creatinine rose up to 838umol/l, urea nitrogen 47.0 mumol/l, ultrasound showed that the blood flow resistance index of transplanted renal artery was 0.87, which was considered as acute rejection. After 3 days of ATG shock treatment, the patient’s renal function gradually returned to normal, and the patient is now in stable condition with normal renal function. Rh-negative patients cannot receive blood from Rh-positive donors. In the case of organ shortage, it is extremely difficult for Rh-negative patients to receive Rh-positive donors; Rh antigen is only present on the surface of red blood cells, and vascular endothelial cells do not express this antigen; few red blood cells are brought into the recipient’s circulatory system by the donor kidney during transplantation, and large doses of immune transplantation agents are applied postoperatively; the percentage of Rh-negative recipients producing anti-Rh antibodies after receiving Rh-positive donor kidneys is low. A group of foreign data showed that the recent survival rate of kidney transplant patients with different donor-recipient Rh blood types was not significantly different, but their 7-year survival rate was significantly lower than that of kidney transplant patients with the same Rh blood type, 58% versus 78%, respectively. Therefore, we believe that different Rh blood types are not a major obstacle to kidney transplantation, and that Rh-negative patients can still receive Rh-positive donor kidneys as long as there is a good match between the donor and recipient, the donor kidney is adequately irrigated, and appropriate immunografting agents are used, but attention should be paid to improving their long-term survival rates.