The aim of this study was to investigate cardiovascular risk markers in renal transplant recipients receiving sirolimus-based regimen (n=21) compared to calcineurin inhibitor based regimen (CNI) based (n=21). Cardiovascular risk markers including asymmetric dimethylarginine (ADMA), nitric oxide, homocysteine and total antioxidant capacity were measured in plasma. Plasma ADMA concentrations for CNI-based and sirolimus-based regimen were 0.60 ± 0.02 µmol/L and 0.52 ± 0.02 µmol/L, respectively (P < 0.05). Plasma concentrations of nitric oxide for CNI-based and sirolimus-based patients were 138.68 ± 28.91 µmol/L and 82.01 ± 9.46 µmol/L, respectively. A level of homocysteine in CNI-based and sirolimus-based groups were 14.34 ± 0.87 µmol/L and 17.33 ± 1.65 µmol/L and a level of total antioxidant capacity were 1072.40 ± 51.67 µmol/L and 1000.51 ± 65.15 µmol/L. These results suggested the higher cardiovascular disease risk in CNI-based than in sirolimus patients as shown by increased ADMA levels and may support the role of Sirolimus-based regimen in reducing the cardiovascular disease risk in this group of patients.