Objective: The effect of the ABO blood group on renal allograft survival (AS) is unclear. We assessed the influence of theABO blood group on AS and performed a comparative analysis of AS in kidney transplant recipients with different ABOblood groups.Methods: The 239 renal transplant recipients who underwent transplantation in a single center were stratified into the3 groups: blood group O (84, 35.14%), blood group A (104, 43.51%), and due to the low number of blood group AB patients,blood groups B and AB were classified as blood group B (51, 21.3%). Clinical outcomes and patient demographics wereinvestigated and compared between groups.Results: The AS of blood group O recipients was significantly longer than that of blood group B recipients (P = .001).Correlation analyses revealed that recipient age (P = .002), donor age (P = .013), creatinine level (P = .022), estimated glomerular filtration rate (eGFR) (P = .005), human leukocyte antigen (HLA) mismatches (P = .001), blood group O (P < .0001),blood group B (P < .0001), cyclosporine A (P < .0001), and sirolimus treatment (P = .032) were predictors of AS. Multivariateregression analyses indicated that blood group B (β = −0.618, P < .0001) and cyclosporine A-based immunosuppression (β= −0.924, P < .0001) were negative predictors of AS.Conclusion: The data presented here showed that eGFR, low recipient age, low donor age, patient gender (male), and3 HLA mismatches were correlated with long-term AS. In contrast, shorter AS was associated with the blood group B andcyclosporine A treatment.