Introduction: Kidney transplantation is the preferred treatment for children with end-stage renal failure (ESRF). In paediatric populations, congenital and developmental renal disorders are major causes of ESRF; however, data describing indications for paediatric renal transplantation in Sri Lanka are limited. Objectives: To describe the demographic profile and underlying indications for paediatric renal transplantation at a tertiary centre in Sri Lanka and to compare indication patterns between age groups. Methods: A retrospective analytical study included children aged