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Background: Though infrequent, allograft nephrectomies are performed for early and late graft loss. The study aims to analyze the histopathologic characteristics of allograft nephrectomy specimens., Materials and Methods: We conducted an observational study of 103 cases of allograft nephrectomies from 21 centers from 2013 to 2023. All the pathology slides, including hematoxylin and eosin-stained sections, masson trichrome, jones methenamine silver, PAS, GMS, AFB, and immunohistochemistry (C4d, SV40) were reviewed. Pathologic findings were analyzed based on the transplant to nephrectomy interval (0-3 months, > 3 months) and type of donor (deceased, live donor)., Results: Of the total 103 cases, 77 were male. The mean age at the time of nephrectomy was 36.4 (range 5-64) years. The allografts were obtained from deceased (57) donors and live related (46) donors. Graft tenderness, oliguria/anuria, and fever were common clinical presentations. The majority (71.8%) of the nephrectomies were performed within the first 3 months of renal transplant. Renal vessel thrombosis (32.03%) was the most common pathologic finding. Infections were more common in the first 3 months after the transplant. Fungal infection had a significant association with deceased donor transplantation (p = 0.029)., Conclusion: Histopathological study of allograft nephrectomy specimens aids understanding of graft loss causes. The study also provides opportunities to prevent complications and implement measures to prolong graft survival in a subsequent transplant., Competing Interests: There are no conflicts of interest., (© 2024 Indian Journal of Nephrology | Published by Scientific Scholar.)