Acute kidney injury is common in critically ill children admitted to intensive care unit.  Sepsis remains a significant risk factor and it is the leading cause of acute kidney injury in critically ill children. The aim of the study is to evaluate the outcome of AKI in critically ill septic children. Sixty eight patients, who met criteria of sepsis and related syndromes, were classified into two groups (AKI and non- AKI groups). Patients with AKI are much younger than those without AKI. Hypervolemia is present in about 28% of patients with AKI and the pulmonary oedema is pesent in about 6% of those patients. Patients with AKI need more support as regard to inotropes, mechanical ventilation and the need for RRT [P value> 0.05] than patients without AKI. Patients with AKI have a higher PRISM score [20 vs.9] and a higher mortality rate [62% vs.8%] than patients without AKI.
 In conclusion, AKI is common among critically ill children and early diagnosis is vital to prevent and decrease associated morbidity and mortality.