Purpose: This study aims to evaluate the effect of remimazolam on induction and maintenance of general anesthesia in kidney transplant patients. Methods: 120 patients undergoing kidney transplant were divided into two groups: Propofol group (Group P) and Remimazolam group (Group R). Anesthesia induction: remimazolam had injected IV at a dose of 0.15– 0.35 mg/kg in Group R, while propofol had injected IV at a dose of 2.0– 2.5 mg/kg in Group P. Anesthesia maintenance: remimazolam was injected IV at a dose of 0.3– 1.0 mg·kg − 1 ·h − 1 and propofol was injected IV at a dose of 1– 12 mg·kg − 1 ·h − 1 in Group R, propofol was injected IV at a dose of 3– 12 mg·kg − 1 ·h − 1 in Group P. All patients have the same remaining anesthesia durgs. Results: Compared with Group P, in Group R the time of disappearance of the eyelash reflex and the time to drop to 60 in BIS was longer ( P < 0.05), the time of awakening was shorted ( P < 0.05), the MAP of T 6 was fluctuated less ( P < 0.05), the incidence of hypotension and injection pain during induction was reduced ( P < 0.001), the incidence of intraoperative bradycardia during operation was reduced ( P < 0.05), the dosages of sedatives drug during maintenance was reduced ( P < 0.05). There was no statistically significant difference in postoperative renal function between the two groups of patients ( P > 0.05). Conclusion: Remimazolam can be safely and effectively used for the induction and maintenance of general anesthesia in kidney transplant patients. Keywords: remimazolam, propofol, general anesthesia, kidney transplant