Objective To explore the psychosocial adaptation status and influencing factors of young and middle-aged recipients in the early stage after kidney transplantation，so as to provide reference for the interventions. Methods A total of 236 young and middle-aged recipients in the early-stage after kidney transplantation were surveyed using the demographic and disease-related questionnaire, Self-report Psychosocial Adjustment to Illness Scale, Brief Illness Perception Questionnaire, and Multidimensional Scale of Perceived Social Support. Results The total psychosocial adaptation score of young and middle-aged recipients in the early stage after kidney transplantation was (65.18±16.39). Multivariate linear regression analysis showed that low education level, self-payment for medical expenses, short time after transplantation, complications, less social support, and negative disease perception were the main factors causing poor psychological and social adaptation in patients (all P<0.05). Conclusion The psychosocial adaptation level of young and middle-aged recipients is poor in the early stage after kidney transplantation, and medical staff should pay attention to its early identification and implement interventions to prolong the function of transplanted organs and improve patients′ psychological and social health.