Abstract Purpose To evaluate the effect of cold ischemia time (CIT) of renal allografts on diffusion and perfusion using intravoxel incoherent motion (IVIM) derived parameters. Material and methods A total of 37 patients with renal allografts (CIT: 27 <15 h, 10 ≥15 h) and 30 individuals with healthy kidneys were examined at 1.5 T using a single-shot echo-planar diffusion-weighted pulse sequence with nine b -values ranging from 0 to 800 s/mm2 . ADC, perfusion fraction f , and the diffusion coefficient D were calculated using the IVIM model. Parameters of allografts stratified by CIT were compared with healthy kidney groups using the Mann–Whitney U test for unpaired data. We computed the Spearman correlation coefficient for correlation with creatinine values. Results ADC, D , and f of transplanted kidneys were significantly lower than in the healthy controls. The long-CIT group showed significantly lower diffusion parameters compared with the short-CIT group mean ± SD: ADC: 1.63 ± 0.14 μm2 /ms, f : 11.90 ± 5.22%, D : 1.55 ± 0.25 μm2 /ms versus ADC: 1.79 ± 0.13 μm2 /ms, f : 16.12 ± 3.43%, D : 1.73 ± 0.14 μm2 /ms, PADC , f , D < 0.05. Conclusion Our results suggest that diffusion parameters, especially the ADC, depend on the CIT of the kidney allograft. Potentially, this stands for functional changes in renal allografts. Diffusion-weighted imaging could be used for follow-up examinations. Thus, diffusion parameters may help guide therapy in patients with delayed graft function.