OBJECTIVE: To investigate the pathological analysis of delayed recovery of transplanted kidney function and preventive and curative measures. METHODS: Eighty-four patients after renal transplantation from December 2007 to September 2010 in the organ transplantation center were selected for the study, 32 of whom were transplanted DGF after renal transplantation, and transplanted kidney puncture biopsies were performed by applying BARD (USA) biopsy puncture needle under ultrasound guidance, and the biopsy tissues were embedded in paraffin and sectioned for routine hematoxylin-eosin staining, histochemical staining, as well as routine C4d Immunohistochemical staining was performed, and pathological staging was performed according to the Banff’05 criteria. The diagnosis was clarified by the pathological status of the transplanted kidney, and the corresponding clinical treatment was carried out to observe the treatment effect. All patients successfully underwent puncture biopsy of the transplanted kidney and were treated with anti-inflammatory and hemostatic therapy for 4 h after puncture without any complications. Results Among the punctured tissues, the main causes of DGF were acute tubular necrosis in 20 cases, acute rejection in 8 cases, and immunosuppressive toxic nephropathy in 4 cases. Thirty-one cases were treated with hemodialysis and one case was treated with surgery. 31 cases of DGF transplanted kidney function returned to normal, and one case of DGF due to AR eventually had the transplanted kidney removed and resumed regular hemodialysis. Conclusion: DGF after renal transplantation is a common complication with a high incidence, ATN and AR are the main factors causing DGF after renal transplantation; the specific situation selects the appropriate hemodialysis modality, it is better to early than late; after determining the hemodialysis-based program, other adjuvant measures are also important, and most DGF can be recovered.