Kidney transplant is the replacement treatment of choice in ADPKD patients with end-stage renal failure. However, the possible coexistence of potential risk factors for serious complications requires careful clinical evaluation and particular preparation of the ADPKD patient who is a candidate for transplantation. This article will take into consideration the main problems an ADPKD patient may present, their possible treatment, and the need for other routine evaluations (clinical, laboratory and instrumental) to exclude the presence of relative or absolute contraindications in kidney transplant candidates.