Purpose: Page kidney is a rare phenomenon following kidney graft biopsy, characterized by subcapsular hematoma causing parenchymal compression, hypoperfusion, renin-mediated hypertension, and graft dysfunction. Early diagnosis and decompression are critical to prevent graft loss. We report a case series and, together with a literature review, develop a paradigm for early recognition, diagnosis, and prompt intervention. Methodology: From January 2013 to December 2025, 5 cases of Page kidney developed among 1,624 percutaneous allograft biopsies (0.31%) in 770 recipients. Clinical presentation varied with 2 cases within 8 hours, 2 cases in 3 days, and 1 case delayed to 10 days following biopsy. Clinical features included pain, hypertension, oliguria, and worsening graft function. Diagnosis was confirmed by Doppler ultrasound and/or CT imaging. Management involved urgent surgical decompression with open capsulotomy/evacuation in 4 cases and laparoscopic surgery in 1 case. Results: Four grafts (80%) were salvaged with timely intervention to restore perfusion. One graft was lost due to delayed presentation causing infarction, despite decompression. Laparoscopic surgery in a complex patient achieved effective hematoma evacuation and restored normal kidney perfusion. Conclusion: The Page kidney phenomenon after percutaneous biopsy is a rare but serious complication that predisposes a high risk of graft loss if presentation and management are delayed. Urgent Doppler ultrasound is essential for diagnosis, with features including elevated resistive index (often 1.0) and loss of diastolic flow. Additional CT imaging helps inform the surgical approach. Laparoscopic capsulotomy is feasible and effective in selected cases. Together with a literature review, we proposed a paradigm to facilitate efficient management of Page kidney and prevent graft loss. Keywords: Page kidney, subcapsular hematoma, renal allograft biopsy, Doppler ultrasound, laparoscopic surgery, graft salvage