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The management of patients with kidney transplant failure (KTF) remains a complex process involving multiple stakeholders. A working group of the Transplantation Commission of the French-Speaking Society of Nephrology, Dialysis, and Transplantation (Société francophone de néphrologie, dialyse et transplantation, SFNDT) conducted a survey on the management of immunosuppressants (IS) after KTF among nephrologists at transplant centers and general nephrologists in France, Switzerland and Belgium between March and June 2023. We analyzed 232 replies from 58 nephrologists at transplant centers and 174 general nephrologists. The average age of these respondents was 43.6 (+10.6) years. In the first three months following KTF, nephrologists reported discontinuing antimetabolite, calcineurin inhibitor (CNI), and corticosteroid treatment in 83%, 39.9%, and 25.8% of cases respectively. Conversely, some nephrologists reported that they were continuing to use CNIs (14%) and corticosteroids (19.1%) on a long-term basis. The patient’s comorbidities associated with the discontinuation of IS treatment are cancer during kidney transplantation (KT), opportunistic infections in the last year of KT or when starting dialysis, or the presence of diabetes during KTF, whereas humoral rejection encourages the IS to be maintained. Transplantectomy is proposed by nephrologists most often for graft intolerance syndrome (86.5%), and more rarely when IS is discontinued (17.6%), or in the absence of plans for new transplantation (9.3%). In multivariate analyses, the presence of a protocol in the center facilitated the management of IS by the general nephrologists. The management of IS after KTF by French-speaking nephrologists is varied. Specific prospective studies are needed to establish new best practice recommendations, based on more robust evidence, which could encourage better adherence by nephrologists.