Although conventional immunosuppressive agents such as calcineurin inhibitors, have substantially reduced the risk of acute rejection, they have had less impact on the long-term survival. This is likely to be related to the adverse effects of such agents in terms of impaired renal function, hypertension, and dyslipidemia. These pitfalls of the currently available agents stimulated the research for biologic agents. Several biologic agents are now in development and hold promise for improved long-term outcomes in renal transplant recipients, particularly in those who receive sub-optimal organs. This article gives an overview of these new biological agents with particular emphasis on belatacept and their possible impact on short- and long-term outcomes, notably on marginal organs.