AbstractIn the period, 1973–1985, a total of 305 renal autotransplantations (often with extracorporeal repair) were performed in 274 patients for fibromuscular (56) or atherosclerotic (98) renovascular disease, nephrolithiasis (97), renal tumor (15), or ureteral injury (8). One‐third of the patients had reduced renal function, and approximately half of the patients with renovascular lesions presented with severe or malignant hypertension. The postoperative mortality rate of 4% was related to age over 60 years and reduced renal function. Postoperatively, 3.6% of the autografted kidneys were lost due to vascular thrombosis (7) or other causes (4). Twenty‐five percent (69) of the patients had a solitary kidney. Two patients died postoperatively with functioning autografts. Long‐term renal function remained stable in 60 patients, and deteriorated in 7.We conclude that autotransplantation and extracorporeal repair provide safe and efficient treatment for selected difficult renal lesions.