The formation of heterotopic bone tissue outside the skeleton, known as osseous metaplasia, is a well-known
phenomenon, but only a handful of cases describe this in renal allografts. We report the case of a 26-year-old female
who was admitted to hospital for repair of an arteriovenous fistula of the right arm. Following her demise, the
incidental finding of osseous metaplasia in the allograft kidney was made at autopsy. The pathophysiology, histology
and possible clinical significance of the lesion are described.