Renal transplantation is the treatment of choice for patients with end-stage kidney disease, offering cost, quality of life, and survival benefits over the alternative of dialysis. Over the past few decades surgical and medical advances have led to continuous improvement in short term graft survival, but this progress has not been accompanied by similar improvements in long-term graft survival and kidney transplant recipients continue to experience late allograft failure. The aim of this study was to estimate long-term survival rate of kidney transplantation and to detect associated prognostic factors. This is a retrospective study included adults who underwent kidney transplantation between 1995 and 2008 in the nephrology department of the Fattouma Bourguiba Hospital in Monastir (Tunisia). They were followed until 31 December 2018.Therefore, this cohort was followed for at least 10 years. Data were collected from patients’ medical records using a checklist. We compared the demographic, clinical, immunological, and laboratory profile of patients who had functional grafts ≥ 10 years after kidney transplantation to those whose transplants survived <10 years. Kaplan-Meier curve, log-rank test was used to compare survival curves and Cox proportional hazard model were used to multivariate analysis. The study cohort included 59 patients with a mean age of 30,83±10,14 years with M:F ratio of 1.68. The mean graft survival was 11.22±4,14 years in the overall cohort. The graft survival rates at 1 ,3, 5, 7 and 10 years were 98,3%,93,2%,89,8%,81,4%and 59,3% respectively. We identified 45 (76 ,3%) patients with a functional graft for 10 or more years after transplantation and 18.6% for 15 or more. In the univariate analyses factors statistically associated to long survival (≥ 10-year) were: recipient age below 35 years (P = 0.016), ABO-identical matching (P = 0.02), higher 3 month (P = 0.01) , one-year (P = 0.01), 5 years (P = 0.02) estimated glomerular filtration rate and no CMV infection after transplantation (P = 0.01). Our experience in renal transplantation survival rates indicate a success rate comparable to those noted in other reports. The renal function at 1-year after transplantation is important for the 10-year survival of kidney transplants. Accordingly, efforts should be targeted to preserving graft function in the first year after kidney transplantation.