Retrospectively we reviewed 761 consecutively performed renal biopsies on 509 patients within 36 months. Among 351 biopsies (39.4%) of native kidneys the main diagnoses were 262 cases of glomerulonephritis and 167 of so-called benign nephrosclerosis, 26 as a main diagnosis. Concerning the 262 cases of glomerulonephritis, the most frequent diagnoses were IgA nephropathy (n = 93, 26.5%), FSGN (n = 42, 12%), minimal change and membranous nephropathy (each n = 34, 9.7%) and intra-extracapillary proliferative glomerulonephritis (n = 30, 8.5%). In 410 graft biopsies (60.6%) 219 biopsies showed interstitial (78%), 14 vascular (5%), and 49 both interstitial and vascular (17%) rejection. Furthermore, 21 cases of glomerulonephritis (5.1%) were discovered among the graft biopsies, including 8 cases of histologically proved recurrent and 8 of de novo diagnosis. In 5 cases no histological diagnosis predecessing renal transplantation became apparent. Only 5 (0.66%) biopsies developed post biopsy clinical relevant complications (3 perirenal hematomas, 1 AV fistula, 1 tamponade of the bladder). Again percutaneous renal biopsy is proven to be a diagnostically efficient and safe tool at the same time even within an enormous amount of a non-selected patient population. The relatively frequent diagnosis of the so-called benign nephrosclerosis seems to indicate the need for an intensified interest on this disease.