The long-term outcome of pancreas transplant (PT) in African Americans (AA) using interleukin-2 receptor antibody induction has not been well documented. We retrospectively analyzed the 7-year outcomes of 45 AA and 73 white recipients of primary PT at our center. All PT were performed with enteric-systemic drainage. Basiliximab induction, tacrolimus, mycophenolic acid, and steroid maintenance were used as the primary immunotherapy. There was no difference by Kaplan-Meier analysis in patient (P = 0.94), pancreas graft (P = 0.76), or death-censored graft survival (P = 0.71) over 7 years between the AA and white groups. Clinically treated pancreas rejection episodes were slightly higher in AA than in white patients. Similarly, cytomegalovirus infection rates and comparable quality of graft function were noted in both groups over 7 years. Excellent long-term patient and pancreas graft survivals can be achieved in AA recipients of PT by using interleukin-2 receptor antibody induction and combination of tacrolimus, mycophenolic acid, and steroid maintenance.