The main objective of the present research was to assess the project implementation challengesrnof kidney transplant project in Ethiopia by considering the only project being implementedrnnationally, in the case of St. Paulâ€™s hospital millennium Medical College. With this objective inrnmind this research assessed the four project implementation challenges related to project team,rnresource, top management support, risk identification and management. Therefore peoplernworking in the different level of the project after identifying the work flow of the projectrnactivities were contacted; including top managers, surgeons, clinicians and support staffsrninvolved in pre, during and post kidney transplant activities were contacted. Using a convenientrnsample a total of 21 quantitative questionnaires were collected supported with ten in-depthrninterviews with key respondents. The data collection was conducted after checking for validityrnand reliability of the questionnaire. SPSS version 20 was employed for the data analysis processrnand a narrative analysis of in-depth interviews was done. The descriptive statistics was used torndescribe the general result of the variables. The mean average scores were presented in a table byrnconsidering the four project implementation challenges considered in the study. In the projectrnteam challenges adequacy of team number was the highest score and provision of on job trainingrnwas with the lowest mean score of 2.52 in which more than 47% of the respondents complainrnabout. Regarding the project resource challenges the highest mean score was on the allocation ofrnappropriate budget where as on time delivery of purchase orders was the lowest mean showingrnmore than 76% proportion of respondents complain. Similarly demand for projectrnimplementation progress reports was observed as a contributor for top management supportrnchallenge. The result also shows highest mean score of possible risk identification at the earlyrnphases of the project. Similarly the in-depth interview findings indicate lack of on job training asrna project team challenge. Delayed request of purchase order and delay in obtaining purchasedrnsupplies were a major challenge in resource related factor. It is recommended that a continuousrntop management support is required to alleviate project implementation challenges and projectrnteam training is necessary for improving project performance and to manage challengesrnappropriately.