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Objective To explore clinical effect of treating acute coronary syndrome (ACS) of renal transplant recipients with percutaneous coronary intervention and its safety. Methods Forty two renal transplant recipients who were diagnosed with acute coronary syndrome and received percutaneous coronary intervention (PCI) in our hospital were selected. Serum creatinine (Cr) and glomerular filtration rate (GFR) were compared before surgery, 48 ~ 72 hour after surgery and one year after surgery. All patients were followed up. Results All patients successfully completed PCI. Contrast-induced nephropathy was not found after surgery. Cr and GFR 48 ~ 72 hour after surgery and one year after surgery had no significant differences with that before surgery (P>0.05). The follow up lasted for (61.2±32.2) months averagely. Of 42 cases, 4 cases died, 6 cases were found with nonfatal myocardial infarction, 4 cases were observed with repeat revascularization and 12 cases had accumulative major adverse cardiovascular events (MACE). Conclusion PCI is proved to be effective in treating renal transplant recipients; no severe complications are found and renal function recovers well after treatment.