Objective To explore the characteristics of self-management behavior changes in kidney transplant patients, and to provide a reference for improving patients′ self-management behavior. Methods Using the grounded theory method in qualitative research, with the researcher himself as the research tool, 17 patients who had received kidney transplantation in the department of urology of a Grade A hospital in Suzhou from April 2020 to March 2021 were selected as the research objects by means of objective sampling method and theoretical sampling method. Six face-to-face semi-structured interviews were conducted at 2 weeks, 2 months, 3 months, 6 months, 1 year, and 2 years after the patients′ discharge from the hospital, respectively, and the interview data was sorted out and analyzed using the method of three-level coding. Results Self-management behavior change in kidney transplant patients presented two distinctive features, namely, the trajectory of self-management behavior in kidney transplant patients (trying, groping, reshaping, and transcending) and the type of behavior change (compliant adherence type , freewheeling type, and wandering between compliant and free wheeling type). Conclusion The self-management behavioral trajectory of kidney transplant patients is a multi-stage change process, and their self-management behavioral change types are complex and diverse. It is suggested that healthcare professionals can develop multi-stage and individualized intervention strategies according to the characte-ristics of patients′ self-management behavior change.