Objective To evaluate the long-term safety of related kidney donors after unilateral nephrectomy. Methods A total of 91 related donors who received nephrectomy in our hospital from 2006 to 2011 were followed up for at least 10 years by outpatient, telephone, or WeChat. During the follow-up period, the serum creatinine, serum uric acid, blood urea nitrogen, estimated glomerular filtration rate (eGFR), hematuria, urinary protein, blood pressure, blood glucose and blood lipids of the donors were detected, and the changes before and after nephrectomy were analyzed. Results At 1 month after operation, the levels of serum creatinine, blood urea nitrogen and serum uric acid of the donor were significantly higher than those before operation (all P＜0.05), but still within the normal range. The patients were followed up for 1, 3, 5 and 10 years after operation. Compared with 1 month after operation, the serum creatinine, blood urea nitrogen and serum uric acid were relatively stable (all P＞0.05). The eGFR of donors of different ages remained relatively stable for a long time after operation. There were 3 cases of endoscopic hematuria and 4 cases of proteinuria after surgery, and these symptoms were relieved after rest and symptomatic treatment. Ten (11.0%) donors developed hypertension 5 (5.5%) developed hyperlipidemia, and 5 (5.5%) developed diabetes mellitus. No patient died. Conclusion Nephrectomy is safe and feasible for healthy related donors. To ensure the safety of the donors, comprehensive evaluation before nephrectomy and regular follow-up after nephrectomy are essential.