Objective: Duration 2006 to 2021. The study population will be all the donors and recipients of the KT. The gender imbalance outcomes will estimate eGFR for separated 4 groups: I-MM, II-FF, III-MF and IV-FM in last 5 years n=101 from 2016 to 2020. The study design is retrospective cohort study. Statistic analysis have Microsoft Excel and SPSS.   Methods: There are 239 KT cases which are from 35 (14.64%) DDKT and 204 (85,35%) LDKT by March 2021. Of the 35 DDKT subjects, 26 (74.3%) are male. Of the 204 LDKT recipients 144 (70.3%) are male and donors 117 (57.3%) are females.  Relationship of donors are most of spouse female 64 (54.7%), mothers 28 (23.9%) and wife’s 8 (6.8%). Clinical characteristics showed higher risk factors for man donors: smoke (83.3%, p< 0.001), metabolic syndrome (uric acid 5.3 ± 3.3 mg/dl, < 0.001) and BMI (25.8 ± 4.2, < 0.001). Result of donor’s socio-economic situation showed high prevalence of economic situation in woman and male donors are lover status. Kidney graft short term outcomes were only 3 /2.9%/ cases of DGF in IV-FM group. Long term outcomes by average plasma creatinin level in all groups was not differences in post KT 6 months and 1 years, but in 3 and 5 years in II-FF and III-MF groups was significantly better then in IV-FM and I-MM   Results: Many factors have been proposed to explain the observed discrepancies between male and female donors and include biological and social reasons. Woman donors for man recipients KT in long term outcomes lower. Gender disparity in Mongolia depends on socio-economical situation.   Conclusions: Objective: Aim of the study is to study the impact of sex imbalance in kidney transplant /KT/ recepient and donor short and long term outcomes and study gender disparity factors in Mongolia.   Methods: Duration 2006 to 2021. The study population will be all the donors and recipients of the KT. The gender imbalance outcomes will estimate eGFR for separated 4 groups: I-MM, II-FF, III-MF and IV-FM in last 5 years n=101 from 2016 to 2020. The study design is retrospective cohort study. Statistic analysis have Microsoft Excel and SPSS.   Results: There are 239 KT cases which are from 35 (14.64%) DDKT and 204 (85,35%) LDKT by March 2021. Of the 35 DDKT subjects, 26 (74.3%) are male. Of the 204 LDKT recipients 144 (70.3%) are male and donors 117 (57.3%) are females.  Relationship of donors are most of spouse female 64 (54.7%), mothers 28 (23.9%) and wife’s 8 (6.8%). Clinical characteristics showed higher risk factors for man donors: smoke (83.3%, p< 0.001), metabolic syndrome (uric acid 5.3 ± 3.3 mg/dl, < 0.001) and BMI (25.8 ± 4.2, < 0.001). Result of donor’s socio-economic situation showed high prevalence of economic situation in woman and male donors are lover status. Kidney graft short term outcomes were only 3 /2.9%/ cases of DGF in IV-FM group. Long term outcomes by average plasma creatinin level in all groups was not differences in post KT 6 months and 1 years, but in 3 and 5 years in II-FF and III-MF groups was significantly better then in IV-FM and I-MM   Conclusions: Many factors have been proposed to explain the observed discrepancies between male and female donors and include biological and social reasons. Woman donors for man recipients KT in long term outcomes lower. Gender disparity in Mongolia depends on socio-economical situation.