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Mineralocorticoid receptor antagonists are among the primary options for renin\u2013angiotensin\u2013aldosterone system blockage, along with angiotensin\u2010converting enzyme inhibitors and angiotensin receptor blockers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this narrative review, we aim to evaluate the efficiency and safety of mineralocorticoid receptor antagonists in kidney transplant recipients, including the potential underlying pathophysiology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The efficiency and safety of mineralocorticoid receptor antagonists in managing chronic kidney disease and proteinuria, either non\u2010nephrotic or nephrotic range, have been demonstrated among nontransplanted patients, though studies investigating the role of mineralocorticoid receptor antagonists among kidney transplant recipients are scarce. Nevertheless, promising results have been reported in pre\u2010clinical and clinical studies among kidney transplant recipients regarding the role of mineralocorticoid receptor antagonists in terms of ischaemia\u2013reperfusion injury, proteinuria, or calcineurin inhibitor\u2010mediated nephrotoxicity without considerable adverse events such as hypotension, hyperkalaemia or worsening renal functions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Even though initial results regarding the role of mineralocorticoid receptor antagonist therapy for kidney transplant recipients are promising, there is clear need for large\u2010scale randomized clinical trials with long\u2010term follow\u2010up 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