Abstract Background and Aims Renal transplant recipients are at risk for infectious complications, with opportunistic infections predominating early after transplant and community acquired infections occurring in late transplant period. Pulse steroid is a form of heightened immunosuppression given to a transplant recipient, usually for treatment of rejection. This study aimed to investigate the effects of early and late pulse steroid therapy on the development of infectious complications in renal transplant recipients. Method Study population was drawn from patients undergoing kidney transplantation in the period between 1st January, 2016 and 31st December, 2020 in the study centre. Early and late pulse steroid therapy was defined based on whether pulse steroid was received within or after 90 days from date of transplant respectively. Patients receiving either early or late (but not both) pulse steroids who were more than or equal to 18 years of age and had at least 90 days of follow up were included in the study. Patients were followed up till 31st December, 2021 or till their death (whichever came earlier). Results Total of 516 patients underwent renal transplantation in the study centre in the specified period, out of whom 128 patients (24.8%) fulfilled the inclusion criteria without fulfilling the exclusion criteria. Out of these 128 patients, 83 (64.8%) and 45 (35.2%) patients received early and late pulse steroids respectively. The 2 groups were similar with respect to respect to baseline characteristics and use of other immunosuppressive agents. The mean values (95% confidence interval) for overall infections in early and late pulse steroid categories were 0.46 (0.31-0.61) and 1.16 (0.55-1.78) episodes per year respectively (p = 0.28). Sepsis occurred at higher rate in patients receiving late pulse steroids, with mean values (95% confidence interval) for sepsis in early and late pulse steroid categories being 0.02 (0.00-0.06) and 0.30 (0.04- 0.57) episodes per year respectively (p = 0.01). Viral infections also occurred at higher rate in patients receiving late pulse steroids, with mean values (95% confidence interval) for viral infections in early and late pulse steroid categories being 0.04 (0.02- 0.09) and 0.23 (0.03-0.43) episodes per year respectively (p = 0.01). Rates of other types of infection did not significantly differ between the 2 categories. A greater proportion of patients receiving late pulse steroids died (4.8% and 17.8% in early and late pulse steroid categories respectively, p = 0.02). Conclusion Late pulse steroid therapy is associated with more episodes of sepsis and viral infections compared to early pulse steroid therapy, although rate of overall infections do not significantly differ between the two groups. This study highlights the importance of surveillance for infections after pulse steroid therapy in renal allograft recipients.