Open bilateral nephrectomy in renal transplant patients may be indicated for various reasons and is associated with a significant rate of morbidity and mortality. Laparoscopic bilateral nephrectomy may favorably influence postoperative recovery but is technically difficult. This case report is the first description of hand-assisted laparoscopic bilateral nephrectomy. We believe this technique significantly shortens the operative time, increases the safety of the procedure, and assures the patient the benefits of minimal invasive surgery in terms of postoperative pain and recovery.