Background/Objectives: The Transplant Evaluation Rating Scale (TERS) assesses the psychosocial risk of transplant candidates; however, its predictive value for outcomes in living-donor kidney transplant (LDKT) recipients remains unclear. This study evaluated the predictive power of the TERS for psychosocial outcomes in LDKT recipients over two years post-transplant. Methods: In this prospective single-center cohort study, 107 LDKT recipients completed assessments pre-transplant (T0), 6 months post-transplant (T1), and 24 months post-transplant (T2). The outcomes measured were mental distress, physical complaints, and perceived social support. Linear mixed-effects models were used to examine the relationship between the pre-transplant TERS scores and outcomes over time. Results: Higher TERS scores predicted increased physical complaints ( p < 0.001) and lower perceived social support ( p = 0.035) at all time points. Additionally, higher TERS scores were associated with greater mental distress between T0 and T2 ( p < 0.001). A hierarchical partitioning revealed that the TERS accounted for 11.9% of the variance in mental distress, 14.6% of that in physical complaints, and 6.0% of that in perceived social support. Conclusions: The pre-transplant psychosocial risk, as measured by the TERS, significantly predicted the psychosocial outcomes in the LDKT recipients over two years, with small-to-medium effect sizes. The TERS may serve as a valuable tool for identifying patients who could benefit from targeted psychosocial interventions to improve their long-term outcomes.