ABSTRACT Introduction This study examined simultaneous pancreas–kidney transplant (SPKt) in Black and White patients to identify disparities in transplantation, days on the waitlist, and reasons for SPKt waitlist removal. Methods Using the United Network for Organ Sharing Standard Transplant Analysis and Research file, patients between January 1, 2009, and May 31, 2021, were included. Three cohorts (overall, SPKt recipients only, and those not transplanted) were selected using propensity score matching. Conditional logistic regression was used for categorical outcomes. Days on the waitlist were compared using negative binomial regression. Results Black patients had increased odds of receiving a  SPKt (OR, 1.25 95% CI, 1.11–1.40, p < 0.001). White patients had increased odds of receiving a kidney‐only transplant (OR 0.48 95% CI, 0.38–0.61, p < 0.001), and specifically increased odds of receiving a living donor kidney (OR 0.34 0.25–0.45, p < 0.001). Conclusion This study found that Black patients are more likely to receive a SPKt. Results suggest that there are opportunities for additional inquiry related to patient removal from the waitlist, particularly considering White patients received or accepted more kidney‐only transplants and were more likely to receive a living donor kidney‐only transplant.