Serum complement profiles of 19 renal transplant recipients were studied serially before and after renal transplantation to determine if there is any relationship between cytomegalovirus (CMV) infection and alteration in the serum complement (C) levels. Most patients had low serum C3 and C4 levels before transplantation, but afterwards these levels increased in some patients. Clq was elevated before and after transplantation. Factor B was low before transplantation, but after surgery, its level approached normal in patients without cytomegalovirus viremia, whereas in those with viremia, Factor B level became even more depressed. Circulating Factor B fragments were found in the sera of five out of seven patients with active cytomegalovirus infection, which suggests activation of the alternative pathway possibly related to active CMV infection.