Owing to their minimally invasive nature, efficiency and availability, radionuclide renal diagnostic studies play an important role in assessing renal transplant function. Various quantitative parameters have been derived from the radionuclide renograms in the follow-up to assess changes in perfusion and function of the transplant kidneys. The aim of this study was to evaluate the changes in renal transplants with technetium-99m dimercaptosuccinic acid scintigraphy. Serial cortical renal scans of 66 patients were reviewed retrospectively. The studies were analyzed regarding the quality of the images and morphology of the kidneys. Cortical renal scintigraphy was unable to provide decisive information for the etiological diagnosis of renal graft dysfunction, thus not allowing a distinction to be made between different clinical situations. Despite being non-specific, it gives information that is not apparent on conventional imaging as well as the extent of pathology, which makes it a sensitive test in the follow-up of transplant pediatric patients. An early scan within the first weeks provides a baseline, which may help in the assessment of future complications.