Background: Renal transplantation is the most effective treatment for end-stage renal disease (ESRD), offering improved survival and quality of life compared to dialysis. However, in Bangladesh, the prevalence of renal transplant recipients remains relatively low due to medical, economic, and infrastructural challenges. Understanding the demographic and clinical characteristics of transplant recipients is crucial for improving transplant outcomes and healthcare planning. Objective: This study aims to assess the prevalence, demographic distribution, primary disease causes, and co-morbid conditions among renal transplant recipients in Bangladesh. Methodology: A cross-sectional observational study was conducted in the Department of Nephrology at Sir Salimullah Medical College & Mitford Hospital, Dhaka, as well as at CKD and Urology Hospital and the Kidney Foundation Hospital and Research Institute, Bangladesh. A total of 105 renal transplant recipients were selected using a purposive sampling method. Data were collected using structured questionnaires, medical records, and laboratory investigations. Statistical analysis was performed using SPSS version 16, with results presented as mean ± standard deviation (SD) for quantitative data and frequency (%) for categorical data. Results: The majority of renal transplant recipients were aged ≤40 years (72.4%), with a mean age of 34.7 ± 8.9 years. Males predominated, with a male-to-female ratio of 7.75:1. Most patients had a normal BMI (74.3%), with a mean BMI of 21.8 ± 3.1 kg/m². The mean systolic and diastolic blood pressures were 124 ± 9 mmHg and 80 ± 6 mmHg, respectively. The primary disease leading to transplantation was undetermined in 83.8% of cases, followed by glomerulonephritis (6.7%), hypertension (3.8%), and diabetes mellitus (1.9%). Hypertension (94.3%) was the most common co-morbidity, followed by proteinuria (13.3%) and retinopathy (12.4%). Conclusion: Renal transplantation in Bangladesh is more common among younger males, with hypertension and glomerulonephritis being major contributors to ESRD. The high percentage of cases with undetermined primary disease highlights diagnostic limitations. Additionally, post-transplant hypertension remains a major challenge, necessitating lifelong monitoring and management. Addressing these epidemiological trends through improved diagnostic capabilities, awareness programs, and healthcare policies can enhance transplant outcomes and accessibility in Bangladesh.