Tandem scanning confocal microscopy (TSCM) is a noninvasive form of vital microscopy that can be used to evaluate superficial uriniferous tubules in living kidneys. Because TSCM has a number of advantages over conventional microscopic examination of renal biopsies, the present study was undertaken to determine whether the histopathological images obtained by TSCM correlate with post-transplant renal function. The kidneys of New Zealand male rabbits were harvested, flushed with Euro-Collins solution, and stored at 0–2°C for periods of 24, 48, 67 and 72 h prior to transplantation. TSCM observation of the kidneys prior to their transplantation revealed characteristic histopathological changes of the superficial proximal convoluted tubules that correlated closely with subsequent post-transplant renal function. These observations indicate that TSCM may be of significant value in evaluating the status of donor kidneys prior to their transplantation.