INTRODUCTION: Advances in pediatric nephrology have resulted in increased survival rates of children on renal dialysis. Renal failure is characterized by multiple organ involvement, including complications in the soft and hard tissues of the oral cavity. Yet, data regarding the oral health status of Egyptian children on renal dialysis is scarce. OBJECTIVES: The aim of this study was to assess the oral health conditions (dental caries, oral hygiene, gingival condition, calculus and enamel hypoplasia) of children undergoing renal dialysis, in Alexandria, Egypt compared to matched healthy controls. MATERIALS AND METHODS: This study was conducted on all available (70) end-stage renal disease children undergoing dialysis, aged 6–18 years recruited from Alexandria University Children's Hospital (AUCH) and its outpatient-clinics (nephrology medicine) and from Sporting Student's hospital (Health Insurance). The data were compared with that of a gender and age matched control group. Data were collected using an interview questionnaire and clinical examination. The mean df, DMF, GI, Pl.I and CSI scores were recorded. Enamel hypoplasia recorded according to Alaluusa et al criteria was also assessed. RESULTS: Dialysis children had significantly higher plaque, gingival, CSI and enamel hypoplasia scores whereas mean DMFT was higher among healthy children. No significant differences were observed between groups regarding dft. CONCLUSIONS: Children undergoing renal dialysis showed significantly worse oral health conditions than healthy controls except for dental caries status. The results of the study suggest a need for dental advice and supervision, and indicate that dental and medical care should be closely integrated for children with renal failure