Purpose: As life expectancy increases, elderly patients represent a growing proportion of renal transplant recipients. Early mortality related to infection has been reported in the literature. This retrospective review aimed to evaluate surgical complications and mortality in elderly (≥65) transplant recipients. Methodology: A retrospective review of a database was conducted of all adult patients who underwent renal transplantation at a single transplant centre between 2021 and 2025. Outcomes in the first 90 days were reviewed and included surgical complications (graded using the Clavien Dindo classification), wound complications and early mortality. Results: 433 patients were included between Jan 2021 and Dec 2025. Mean age at transplant was 51.13 and patients were grouped into age <65 and ≥65 (n=355, n=89). BMI was not significantly different between groups (27.7; 27.4, p=0.299). Charlson Comorbidity Index was slightly higher in the ≥65 group (3.05; 3.80, p<0.001). Rates of clinically relevant surgical complications (≥ 3a Clavien Dindo) trended higher in the ≥65 group (23.3% vs 28.1%, p=0.343). Superficial surgical site infections were uncommon and did not differ significantly between age groups (2.7% vs 0.0%, p=0.128). Deep surgical site infections occurred more frequently in patients aged ≥65 years (1.5% vs 4.9%, p=0.083). 4 of the 5 mortalities were in patients over 65 (0.3% vs 4.5%, p<0.001), with all deaths occurring in patients aged 60 or over. All four patients ≥65 had infection-related deaths, and one death was secondary to subarachnoid haemorrhage. Conclusion: Elderly patients ≥65 undergoing renal transplantation have a higher mortality rate in the first 90 days compared to those <65 years. However, overall there is no significant difference between post-operative surgical complications. Infection remains an important cause of early mortality in elderly patients and should be a consideration in the post-operative management of elderly patients.