Introduction: Simultaneous liver-kidney transplantation is indicated for patients with concomitant end-stage liver disease and end-stage renal disease. The traditional technique involves separate implantations of the liver and the kidney. In the en bloc approach, the liver is recovered en bloc with the right kidney and the donor renal artery is anastomosed to the donor splenic artery.Objective: To compare the outcomes of the traditional and en bloc techniques for simultaneous liver-kidney transplantation in a single center.Methods: Single-center retrospective study involving all adult patients who underwent simultaneous liver-kidney transplantation with brain-dead donors from January/2017 to December/2022.Results: A total of 15 patients were included, being 10 transplanted with the traditional technique and 5 with the en bloc one. Patients in the en bloc group presented higher body mass index, shorter cold and total kidney ischemia time, shorter overall surgical time and longer kidney ischemia time (29.07 vs 23.20kg/m2, p=0.048; 560 vs 880min, p=0.026; 615 vs 908min, p=0.025; 405 vs 485min, p =0.046; 46 vs 33.5min, p=0.027, respectively). Ureteroneocystostomy was performed in 2 patients of the en bloc group and ureteroureterostomy in the remaining 3 patients. One patient in the en bloc group presented stenosis of renal artery anastomosis and underwent percutaneous angioplasty. This same patient eventually developed late urinary fistula. In the traditional technique group, there were two cases of renal vein thrombosis and one of ureteral stenosis.Conclusion: Compared to the traditional technique, the en bloc approach is feasible and safe, reducing the total surgical and kidney ischemia times.