The kidneys are vital organs that loca ted at the rear of the abdominal cavity in the retroperitioneal space.In case of non-reversible kidney failure (e.g.end-stage renal disease,ESRD),the patient have to require kidney transplant-a surgical procedure to replace diseased kidne y with a healthy donor kidney.However,acute tubular necrosis (ATN) induced by is chemia is a major risk factor for delayed graft function (DGF) and failure of kid ney transplant.Currently,there is no reliable non-invasive method for the detec tion of ATN in donor kidney.Optical coherence tomography (OCT) is an emerging me dical imaging technique that enables high-resolution cross-sectional imaging o f microstructures of biological tissues in situ and in real time.Animal and huma n studies suggest that OCT examination might provide a useful imaging tool in th e evaluation of the status of living kidney.As an optical biopsy tool,the advanc ed OCT system is able to visualize renal surface microstructure that could by us eful in monitoring donor kidney during kidney transplantation.In conjuction with laser Doppler,the OCT/DOCT imaging modality can reveal high-resolution 3D imag es of living kidney in real time.This review will provide an overview on the new method and technique in OCT examination of living kidney.