The recipient, a 31-year-old man, was diagnosed with severe diffuse hypokinesis of left ventricle and diastolic dysfunction by echocardiography before the renal transplantation. His left ventricular ejection fraction (LVEF) was 29%. Therefore we had to postpone the operation and tried to improve his cardiac function. We controlled his dry weight more strictly with hemodialysis and limited in take of salt and water to reduce preload of his heart and administered erythropoietin to improve his anemic condition. We administered angiotensin-converting enzyme inhibitors (ACEI) to control his blood pressure and reduce afterload of his heart. Two months later, his cardiac function was marked improved (LVEF, 29% to 47%), and he underwent renal transplantation. Five months after the operation, improvement of his cardiac function kept on being observed in spite of the cessation of treatment for his heart (LVEF, 47% to 68%). Successful renal transplantation can significantly improve the cardiac function of patients on maintenance dialysis.