Let p and q be distinct primes. We characterize transitive groups G that admit a complete block system of q blocks of size p such that the subgroup of G which fixes each block set-wise has a Sylow p-subgroup of order p. Using this result, we prove that the full automorphism group of a metacirculant graph Γ of order pq such that Aut(Γ) is imprimitive, is contained in one of several families of transitive groups. As the automorphism groups of vertex-transitive graphs of order pq that are primitive have been determined by several authors, this result implies that automorphism groups of vertex-transitive graphs of order pq are known. We also determine all nonnormal Cayley graphs of order pq, and all 1/2-transitive graphs of order pq.