Globally each year more than 30 000 people become living kidney donors. In the UK there have been more than 1000 living kidney donations every year since 2009.2 There are two types of kidney donation, living and deceased. Living donor kidney transplantation offers the best treatment in terms of life expectancy and quality of life for most people with kidney failure (see box 1), the prevalence of which is steadily rising. Living kidney donation is constantly evolving, with new ways of maximising recipient opportunities and increasing information regarding long term outcomes associated with donation. This review presents an overview of current practice covering who can donate, to whom, and the possible impact of donation on the donor’s health.