Surveillance (or “protocol”) biopsies have been procured after kidney transplantation since the 1980s. These biopsies, obtained at set intervals post-transplant, regardless of renal function, have led to major advances in our understanding of the pathophysiology of alloimmune and other forms of graft injury, and have resulted in improved patient and graft survival. Moreover, as kidney transplants are offered to an increasingly older and more complex patient populations, we feel that clinical decisions are often require the use of surveillance biopsies for better patient management. Regrettably, surveillance biopsies are still only performed in a minority of renal transplant centres, despite their safety (complications in about 2/1000).     In this brief talk I will present data from our centre that discusses (a) TCMR in surveillance vs. ‘for cause” biopsies in the current era of immunosuppression and their differences in follow up in repeat surveillance biopsies and (b) surveillance biopsies in an ongoing study of tacrolimus minimization.