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We present an overview of kidney transplantation activity in the Maghreb countries, based on data from the 9th France-Maghreb Symposium (Paris, May 20 and 21, 2022). For Algeria, Morocco, and Tunisia, the incidence of end-stage renal failure is 120, 130, and 130 per million inhabitants, respectively. Its prevalence is 626, 900, and 833 per million inhabitants, and the percentage of patients with a functional graft is 10.3%, 1.8%, and 8.5%, with an annual number of transplants of 6.5, 0.8, and 8.7 per million inhabitants. Living donor transplants account for 99% of transplants in Algeria, 93% in Morocco, and 80% in Tunisia. In conclusion, access to transplantation remains low in the Maghreb countries, and all the modalities (living donor transplants, with an expanded donor pool, and deceased donor transplants) must be further developed. Recommendations have been issued to this end.