Abstract Hematopoietic stem cell and solid organ transplant recipients diagnosed with biopsy-confirmed posttransplant lymphoproliferative disorder (PTLD) at our institution from 1989 to 2010 were identified. Patient-, transplantation- and disease-related characteristics, prognostic factors and outcome were collected and analyzed. One hundred-forty biopsy-proven PTLD cases were included. Overall incidence in the transplant population was 2.12% with heart transplant recipients carrying the highest risk. Most PTLDs were monomorphic (83.6%) with diffuse large B cell lymphoma being the most frequent subtype. The majority of cases (70.7%) occurred > 1 year posttransplantation, whereas 66% were Epstein Barr virus positive. Following initial therapy overall response rate was 68.5%. Three-year relapse-free and overall survival were 59% and 49%, respectively. At last follow-up 44% of the patients were alive. Multivariable analysis identified several classical lymphoma-specific poor prognostic factors for the different outcome measures. The value of the International Prognostic Index was confirmed in our analysis.