Background: Kidney biopsy is frequently performed in our centre as an outpatient procedure. The aim of this study was to evaluate the safety of biopsy in the outpatient setting. ----- Methods: We analysed kidney biopsies performed from March 2013 to February 2017. 725 biopsies performed in the outpatient setting were identified: There were 592 transplant and 133 native biopsies including 3 solitary kidney biopsies. All were performed under ultrasound guidance using a 16G or 18G needle, with freehand technique. In all patients with eGFR<30ml/min/1.73m2 desmopressin was administered. Patients were observed for 6h before discharge, with a CBC and urine test after 4h. Major complications were haemorrhage requiring therapeutic intervention or transfusion. Minor complications were significant reduction in Hb levels (>10%), without need for transfusion or intervention and macrohaematuria. ----- Results: There were 506 (69.8%) male patients. Average age was 50.3 ±12.7 yrs. Indications for native kidney biopsy included nephrotic syndrome (39.8%), nephritic syndrome (42.9%), follow-up biopsy (15.8%), and other (1.5%). There were no major complications. A decline in Hb was observed in 72% of pts. Average Hb decline was 4.2±6.3 g/L. In 10.1% pts there was >10% reduction in Hb level, with no evident bleeding, including by ultrasonography. In 2.5% of patients macrohaematuria was present. In a multivariate analysis male gender, lower eGFR, higher prebiopsy Hb and native kidney biopsy were predictive for Hb decline. No therapeutic interventions were required. ----- Conclusion: We found that kidney biopsy performed in an outpatient setting in select patients is only rarely associated with adverse events and is a safe procedure. It remains a possibility in low-risk patients. In other patients it should be done in the hospital setting due to possibly serious complications.