The clinical evaluation of the renal transplant candidate is a complex medical procedure. Its final goal is to select the patients in whom renal transplantation is likely to improve the clinical outcome. Potential candidate should be referred to the transplant center within six months from the onset of dialysis. The first step of the evaluation is to identify those conditions such as active alcohol or drug abuse, cancer, infections which may represent a major barrier to a successful transplant. If present, they should be removed before any further step in the evaluation process. Special attention should be focused on the detection of any active neoplastic disease and an adequate disease free interval, generally between 2 and 5 years, should be allowed prior to transplant. Similarly, careful evaluation and treatment of any active infectious disease should be undertaken prior to transplant. Cardiovascular diseases represent the major cause of death in patients with renal failure as well as in transplant recipients. Their detection and treatment in the evaluation process greatly improve the clinical outcome of the transplant recipients.