To evaluate the effect of cold ischemia time (CIT) of renal allografts on diffusion and perfusion using intravoxel incoherent motion (IVIM) derived parameters.A total of 37 patients with renal allografts (CIT: 27 <15h, 10 ≥15h) and 30 individuals with healthy kidneys were examined at 1.5T using a single-shot echo-planar diffusion-weighted pulse sequence with nine b-values ranging from 0 to 800s/mm 2 . ADC, perfusion fraction f, and the diffusion coefficient D were calculated using the IVIM model. Parameters of allografts stratified by CIT were compared with healthy kidney groups using the Mann–Whitney U test for unpaired data. We computed the Spearman correlation coefficient for correlation with creatinine values.ADC, D, and f of transplanted kidneys were significantly lower than in the healthy controls. The long-CIT group showed significantly lower diffusion parameters compared with the short-CIT group [mean±SD]: ADC: 1.63±0.14μm 2 /ms, f: 11.90±5.22%, D: 1.55±0.25μm 2 /ms versus ADC: 1.79±0.13μm 2 /ms, f: 16.12±3.43%, D: 1.73±0.14μm 2 /ms, P ADC , f , D <0.05.Our results suggest that diffusion parameters, especially the ADC, depend on the CIT of the kidney allograft. Potentially, this stands for functional changes in renal allografts. Diffusion-weighted imaging could be used for follow-up examinations. Thus, diffusion parameters may help guide therapy in patients with delayed graft function.