Doppler evaluation of transplanted kidney intraparenchymal arteries is valuable investigation for assessment of transplanted kidneys by the estimation of resistive index from these arteries by the spectral waveform Doppler analysis and the degree of parenchymal perfusion by both the color and power Doppler mapping. The aim of this study was to correlate the resistive index (RI) value and the degree of parenchymal perfusion with serum creatinine level in renal transplant patients. Cross sectional study obtained from 43 kidney transplant patients who underwent duplex Doppler scanning of their transplanted kidneys for arterial perfusion evaluation. The patients categorized into four groups according to the level of arterial tree pruning. Also spectral waveform Doppler analysis for Resistive Index (RI) measurement and the patients were categorized as elevated Resistive Index (RI) if more than or equal to 0.7 and normal if less than 0.7 readings. We find a significant correlation (p<0.001), by multimodalities of statistical analysis, between the Resistive Index (RI) value and the serum creatinine level reaching about (95%). In addition, there was a significant correlation between the degree of arterial pruning level and the serum creatinine level. We notice that the Resistive Index (RI) value and the severity of pruning increase with the increment of serum creatinine. There is a significant linear correlation between serum creatinine level and Resistive index (RI) value in transplanted kidney and the severity of parenchymal vascular pruning sign seen on color and power Doppler is increased with the increased Resistive index (RI) value.