Polycystic kidney disease (PKD) is characterized by the formation and development of cysts that cause progressive enlargement of the kidneys. Approximately 50% of patients with PKD develop end-stage renal failure requiring dialysis or kidney transplantation. From January 2022 to July 2023 at Cipto Mangunkusumo Hospital, Indonesia, kidney transplants carried out in three stage 5 chronic kidney disease patients with PKD gave good postoperative results. Case 1, a 35-year-old man with PKD whose cysts enlarged rapidly with bleeding and infection, needed repeated transfusions and nephrectomy dextra before kidney transplantation. Case 2, a 50-year-old man with PKD could undergo kidney transplant surgery with implantation on the right side without nephrectomy and complications. Case 3, a 23-year-old man with PKD underwent kidney transplantation with left implantation due to stenosis of the right iliac artery, the operation went well with satisfactory results. Kidney transplantation in PKD has several obstacles, namely the narrow location of the allograft kidney, recurrent urinary tract infections, massive hematuria, repeated transfusions, abdominal pain, weight loss, and resistant hypertension. Indications for nephrectomy are active bleeding causing repeated leuko-depleted pack red cell transfusions, abdominal pain due to cyst rupture, narrow space for the allograft kidney, and partial obstruction of the large intestine. Repeated transfusions before surgery will increase human leukocyte antigen sensitivity, longer waiting times, and increase the risk of early and late-phase graft loss. Kidney transplantation in patients with PKD has various obstacles but has a good prognosis.