Background: Kidney transplantation is the gold standard treatment for end-stage renal disease patients. Tacrolimus is the backbone of most of maintenance immunosuppressive protocols nowadays. Achieving accepted Tacrolimus trough level is multifactorial. Previous research suggested presence of genetic varieties responsible for the heterogenicity of tacrolimus doses required to achieve satisfactory trough level. Purpose: Revise the already published data about effect of genetic polymorphisms on tacrolimus doses in kidney transplant recipients. Methods: Published research from google scholar, MIDLINE, Web of Science and PubMed were reviewed for valid articles and studies which evaluated certain types of genetic polymorphisms which affected tacrolimus doses among kidney transplant recipients in particular, cytochrome 3A4 and 3A5 genetic polymorphisms. Conclusion: CYP 3A4 and CYP 3A5 plays crucial role in determining tacrolimus doses required to achieve accepted trough level among kidney transplant recipients.