Patients with obesity are the largest and fastest-growing demographic among individuals with renal failure in the United States. Transplant centers often reject patients with high body mass index due to the risk of posttransplant complications. Metabolic bariatric surgery, the most efficient and durable weight loss method, can facilitate a timely kidney transplant listing and improve obesity-related comorbidities in a relatively safe manner. In this review, we identify kidney transplant candidates who are likely to benefit from metabolic bariatric surgery, discuss the potential risks of the procedure, and propose postsurgery monitoring and management to optimize safety and maximize the benefits of this therapy.