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Objectives The overall effect of pamidronate on bone mass density (BMD) in the early renal transplant period varies considerably among studies.The effects of pamidronate on graft function have not been determined.Methods A comprehensive search was conducted in PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL) and Embase (updated on December 15th 2013) independently by two authors (Wang and Han).Randomized controlled trials of pamidronate evaluating bone loss in the first year of renal transplantation were included.Methods reported in the "Cochrane Handbook for Systematic Reviews of Interventions 5.0.2" were used to evaluate changes of lumbar spine and femoral neck BMD, and serum creatinine, calcium and intact parathyroid hormone (iPTH) levels.Fixed or random effect models were used as appropriate.