Abstract: Kidney transplantation is the preferred treatment option for end-stage renal disease. Although early prognosis has significantly improved, the long-term survival rate has not increased substantially. There are still significant challenges in addressing organ shortage, maintaining the quality of donor kidneys, and preventing and managing postoperative complications. Nanotechnology, with its unique physicochemical and biological advantages, shows broad application prospects in maintaining graft function while achieving precise immune regulation and complication management, providing new opportunities for the diagnosis, treatment and management of kidney transplantation. The applications of nanotechnology include donor kidney protection, human leukocyte antigen typing of donors and recipients, early diagnosis of postoperative complications such as rejection and infection, and targeted treatment of ischemia-reperfusion injury and rejection. This article systematically reviews and discusses the relevant research progress, evaluates the advantages and potential risks of nanotechnology in kidney transplantation, and explores the challenges and development directions for its clinical translation, aiming to provide references for promoting the precise and individualized management of kidney transplantation.