This study was taken to evaluate etiology, presentation, complication and outcome of the patients suffering from Acute Renal Failure. A total of 50 patients, Suffering from acute renal failure, ranging from 3 - 15 years of age, were evaluated of age for period of 3 years (1998 - 2000) at Nephrology Department, Postgraduate Medical Institute, LRH, Peshawar. Peritoneal dialysis was the main modality of treatment. Kidney biopsies were performed in 22% of the cases. Patients with history of renal insufficient, urological surgery were excluded from the study. Paediatric Acute Renal Failure is a serious medical emergency. Late referral malnutrition, lack of faculties at periphery hospital and poor socio economic condition contribute to high mortality. Early referral, fluid balance, close monitoring of BP, Keeping GN as a possiblity in peadiatric population with hypertension and judicious use of fluids in as oligouric child with renal fialure is the best way to prevent further damage.