Objectives: Little is known about the time-varying risk factors for fractures in kidney transplant recipients (KTRs). This study investigated the incidence, location, and time-varying predictors of fracture following kidney transplantation (KT). Methods: Data were obtained from the Korea Organ Transplantation Registry, a nationwide cohort study of KTRs. A total of 4,134 KTRs who received KT between January 2014 and June 2019 were included. Cumulative incidence and risk factors of fracture were evaluated using Kaplan-Meier method and Cox proportional hazard model. Results: During a follow-up of 12,441.04 person-years (median 2.94 years), 63 patients developed incident fracture. The cumulative incidence of fracture was 2.10% at 5 years. The most frequent locations of fracture were leg (25.4%) and foot (22.2%). In multivariable analysis, older recipient age at baseline (hazard ratio [HR], 1.035; 95% confidence interval [CI], 1.0071.064; P = 0.013) and higher tacrolimus trough level (HR, 1.112; 95% CI, 1.029 1.202; P = 0.029) were associated with higher risks for fractures. Diabetes mellitus had a time-dependent impact on fracture, with increasing risk as time elapses (HR for diabetes mellitus 1.115; 95% CI, 0.439-2.832;P= 0.818; HR for diabetes mellitus x time, 1.049; 95% CI, 1.0071.094; P = 0.022). Conclusions: KTRs had high risk of peripheral skeletal fractures in the first 5 years. Baseline recipient age, comorbid diabetes mellitus and tacrolimus trough level after KT were responsible for the fractures in KTRs.