Introduction. Cardiovascular events are a major cause of mortality and morbidity in end stage renal disease (ESRD) patients. This could be attributed to the impaired baroreflex function observed in them (1). The effect of renal transplantation on the baroreflex sensitivity (BRS) in ESRD patients has been poorly addressed. Therefore, we investigated BRS and its relation to arterial stiffness indices and cardiovascular variability parameters (heart rate and blood pressure variability – HRV and BPV) in ESRD patients before and after transplantation. Methods. We studied 23 ESRD patients (mean age; 35.9 ± 9.3 yrs) prospectively before and at 3 and 6 months after renal transplantation. BRS was determined by spontaneous method [sequence and spectral] (2). Short term HRV and BPV were assessed using frequency domain analysis of RR intervals and systolic blood pressure values recorded beat to beat over a duration of 5 minutes (3, 4). Arterial stiffness indices were measured by carotid femoral pulse wave velocity (PWV), augmentation index (AI) and central pulse pressure (5) using Sphygmocor Vx device (Atcor medical, Australia). Data which followed normal distribution are expressed as mean± SD and analysed using Repeated measures ANOVA with Tukey’s post hoc multiple comparison test. Data with non-normal distribution are expressed as median with inter-quartile range (1st quartile – 3rd quartile) and analysed using Kruskal Wallis test with Dunns post hoc multiple comparison test. Results. Renal transplantation was associated with the normalisation of BRS [11.4±7.9 ms/mmHg at 6 months vs. 6.7±3.1 ms/mmHg at baseline; p<0.05] only by 6 months. Arterial stiffness indices – AI [27.7±11.3 % vs. 17.1±9.0 %; p<0.05] and central pulse pressure [41.7±13.9 mmHg vs. 33.0±11.1 mmHg; p<0.05] showed a significant reduction as early as 3 months after renal transplantation. PWV and frequency domain measures of heart rate variability after renal transplantation did not show statistically significant changes except LF/HF ratio which had significant increase only at 6 months as compared to baseline. Systolic BPV total power [134.0 (118.7-149.5) mmHg2 /Hz vs. 100.4 (78.6-127.1) mmHg2 /Hz] showed a significant reduction as early as 3 months after renal transplantation and showed similar reduction in comparison to baseline at 6 months also. Conclusions. Our data suggests that renal transplantation normalises BRS in end stage renal disease patients by 6 months which follows the improvement in the arterial stiffness indices observed as early as 3 months post renal transplantation. This improvement in BRS at 6 months reduces the blood pressure variability in renal transplant patients.