We report the case of kidney graft dysfunction secondary to ureteral obstruction caused by an inguinal hernia. A 52-year-old renal transplant recipient was admitted to our transplantation unit for abdominal pain and acute rise in serum creatinine level. Radiological work-up showed that the distal transplant ureter was trapped in a left inguinal hernia. After placement of a temporary percutaneous nephrostomy tube and hernia repair by the Shouldice technique, the graft function improved and has remained stable at 1 year of follow-up. Although infrequent, inguinal hernia can be a cause of obstructive uropathy and graft failure in a transplanted kidney, and the Shouldice technique is appropriate for cure of hernia in this setting. Dial. Transplant. © 2011 Wiley Periodicals, Inc.