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Introduction: Antithymocyte Globulin (ATG) induction in renal transplantation, although currently most common in western world, is used sparingly in India primarily due to concerns regarding infective risks. A recent trial (Brennan D C et al, NEJM 2006), which showed no major difference hi the risk profile, prompted us to do this study Aims and Objectives: To study the efficacy and safety of rATG induction hi renal transplant recipients with particular reference to CMV and non CMV viral infections. 2. To compare the results with that of IL-2 receptor blockers. Materials and Methods: We studied 15 renal allograft recipients who received induction therapy with rabbit ATG (Dose: 1.25-1.5 mg/kg) between September 2006 and August 2007 and compared with other 2 groups (15 patients each) who had received either Basiliximab or Daclizumab in the past or concurrently at our center. All the recipients in the ATG group received Tacrolimus, MME Methyl prednisolone followed by Prednisolone as maintenance immunosuppression. Results: In the rATG group, the median age of the recipients was 37 yrs, and that of the donors was 43 yrs. All the recipients had undergone first kidney transplantation except 1 patient who had received second transplantation. 60% of patients (9115) had HLA mismatch of 5 or more and 26.67% (4/15) had mismatch of 3 - 4. CMV seropositivity: 60% (9/15) were D+/R+; 26.67% (4/15) were D+/R-. The HLA matching and CMV seropositivity were comparable in the three groups. Prophylactic Acychivir and Trimethoprim -- Sulphamethoxazole were given in all the patients. Renal function was stable at the end of 1 month, 6 months and 12 months. No incidence of acute rejection or delayed graft function was noted. There was no incidence of thrombocytopenia or leucopenia. 66.67% (10/15) of the patients has completed 3 months post transplant and 46.67% (7/15) - 6 months: no incidence of CMV or non CMV viral infection noted. Among the adverse events, UTI was most common. There were 3 episodes of UTI, 1 incidence of PTDM and 1 incidence of worsening of pre existing diabetes mellitus. The observations were similar in the other 2 groups who had received either Basiliximab or Daclizumab as induction therapy. The overall cost of ATG is 20% less compared to IL2 receptor blockers. Conclusion: In our study, use of rATG as induction therapy was found to be safe and effective. No CMV infection was noted despite seropositivity and absence of gancyclovir prophylaxis. Acyclovir might have contributed, however the exact role is uncertain. rATG is cost effective induction therapy without any increased incidence of CMV and non CMV infection in comparison to IL2 receptor blocker. [ABSTRACT FROM AUTHOR]