The wish for a minimally invasive procedure is one of the utmost demands by all persons undergoing living-donor nephrectomies. The retroperitoneoscopic access for this procedure has proven to be a safe, minimally invasive, and efficient approach accompanied by early mobilization and a fast return to general daily activities. The incidence of complications during and after this technically demanding operation is comparable to that of other approaches. Because of the direct anatomic approach, retroperitoneoscopic living-donor nephrectomy has become the preferred access at our institution for both donors and surgeons.