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To evaluate the value of ATP level of CD4+T lymphocytes in estimating the chance of infection for patient undergoing renal transplant; and to study the correlation between ATP level and drug concentration. Peripheral blood from 45 renal transplant recipients and 23 healthy volunteers were tested for ATP level of CD4+T lymphocytes by Cylex Immuknow assay. A total of 129 samples were tested. The recipients were divided into non infection group (n = 34) and infection group (n = 11) according to the clinical manifestation. The trough concentrations of the FK506 and CsA were detected by microparticle enzyme immunoassay and fluorescence polarization immunoassay, respectively. The hs-CRP concentration was detected by immunoturbidimetry. 11 cases of infection were diagnosed by the chest X-ray, CT imaging manifestations and etiological examination. 5 of 11 cases were pulmonary infection, 4 of 11 cases were upper respiratory infection, 1 of 11 cases was urinary tract infection, and 1 of 11 cases was perineal abscess. The ATP concentration of healthy volunteers, non infection group and the infection group were 295 ± 73.7 ng/ml, 335 ± 189 ng/ml and 212 ± 155 ng/ml respectively. The ATP level of infection group was obviously lower than the healthy volunteers and non infection group. These differences were statistically significant (P = 0.041, P = 0.043). Among 24 followed up recipients, there were 4 cases whose ATP level was lower than the postoperative average level in 5 infection recipients. The hs-CRP concentrations for infection group were obviously higher than the non infection group. The difference was statistically significant (P < 0.001). The ATP level of CD4 + T lymphocytes was not so associated with drug trough concentration. Low ATP level for recipient after renal transplantation is a risk factor of infection. Cylex Immuknow assay can make up for the inadequacy of the drug concentration monitoring, and help come to reasonable immunotherapy to reduce the risk of infection.