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Tumor necrosis factor alpha (TNF α) is a cytokine secreted by macrophages, helper T cells, Natural Killer cells, B lymphocytes and non lymphoid cells e.g. endothelial cells, fibroblast and tumor cell lines. Aim of the study was to find the utility of TNF α in diagnosing renal transplant rejection among the renal transplant cases (n=29), and comparison with the levels in patients on maintenance hemodialysis (n=21) and healthy controls (n=20). TNF α in healthy controls varied from 2 to 15 pg/mL. In chronic renal failure and renal transplant rejection cases TNF α was above 45 pg/mL. In stable renal transplant patients it was higher than normal (16 to 30 pg/mL). In both acute and chronic transplant rejection TNF α increase correlated well with histology. Thus our study suggests that TNF α level more than 45 pg/mL can be taken as an immunological marker of renal transplant rejection.