The number of elderly patients (> 65 years) on the national waiting list of kidney transplantation and subsequently transplanted has increased 5 times from 1990 to 2004. Transplantation in patients more than 70 years old is not exceptional today. Graft survival is significantly less than in younger patients, but this difference disappears when deaths are censored. Elderly patients generally receive marginal kidneys from aged donors with cardiovascular pathologies or risk factors, which would only reluctantly be transplanted in younger people. Patient survival is significantly better after transplantation than in dialysis and the age of the patient per se should no longer be a contraindication to transplantation. Because of organ shortage and the need for transplanting these aged patients as soon as possible, it appears necessary to find new sources of transplants, harvested from donors with expanded criteria and previously considered inadequate.