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AIMS Evaluate the weight trajectories after pancreas transplantation (PT) and their relationships with pancreas graft outcomes in type 1 diabetes (T1D). METHODS Retrospective cohort study. T1D individuals who underwent PT were recruited (T1D-PT; n=194) and divided into three groups according to transplantation date: 1999-2004 (n=57), 2005-2009 (n=79), 2010-2015 (n=58). For weight comparisons, a random sample of T1D without renal impairment was also recruited during 2015 (n=61; T1D-control). RESULTS The median follow-up for the T1D-PT group was 11.1 years. Despite significant weight loss at 6 months (65.7±12.4 vs. 64.1±11.4 Kg; p<0.001), a stepped increase was seen thereafter (60 months: 68.0±14.0 Kg; p<0.001). Participants from the 2010-2015 period showed higher weight gain (p<0.001), outweighing that observed in the T1D-control (60 months: 4.69±8.49 vs. -0.97±4.59 Kg; p=0.003). Weight gain between 6-36 months was directly associated with fasting glucose and HbA1c at 36 months, and with HbA1c at 60 months (p<0.05). However, in Cox-regression models adjusted for age, sex, and several recipient and PT-related variables, the third tertile of weight gain between 6-36 months showed a non-significant increase in the graft failure/dysfunction (HR 2.33 [0.75-7.27]). CONCLUSIONS Weight gain post-PT was associated with glucose-related biochemical markers of graft dysfunction, which needs confirmation in further studies.