Data on kidney transplantation (KTx) in patients with an MGRS-associated kidney disease are limited due to the risk of recurrence that had discouraged KTx in these patients. This case series reports on a single center’s experience with and without treatment of MGRS prior to KTx. Recurrence was common in patients who did not receive treatment for MGRS prior to KTx. Histologic recurrence was often responsible for graft loss and hematologic relapse/progression was frequently the cause of death. Achieving a CR prior to KTx appeared to reduce the risk of recurrence/relapse and possibly improved overall survival. Treatment of the MGRS seemed to stabilize allograft function in many of those who relapsed, but allograft losses and deaths still occurred despite hematologic response. Outcomes of MGRS after KTx are heterogeneous and more studies are needed to determine the optimal hematologic response before proceeding to KTx and to identify optimal treatment of recurrences.