Chronic renal failure (CRF) is one of the most chronic diseases which are considered a major public health problem affecting human societies at all stages of development. It is characterized by a complete and irreversible loss of kidney function that requires dialysis or kidney transplantation to sustain life. This study aimed to assess the effectiveness of using Children Apperception Test (CAT) in assessing depression among children with chronic renal failure. The study was conducted in Hemodialysis Unit at El-Mansoura University Children's Hospital and Hemodialysis Unit at National Hospital of Sandoup in Mansoura City. A conveniance sample of 74 children aged 6 to 10 years, who are diagnosed with chronic renal failure since 6 months or more and free from other chronic illness .Three tools were used to collect necessary data which included a semi- structured interview questionnaire, The children's depression inventory to assess presence of depression among studied children and the children apperception test. Results: The results of this study revealed that the majority of studied children had depression with different level (91.9%) compared to 8.1% of them who had non depression and the children apperception test was effective in analyzing internal conflict and revealed hidden emotions that manifested depression. Recommendations: Regular and continuous training courses should be provided to nurses in order to improve their knowledge and practices regarding depression's assessment by using projective tests and team of nurses and psychologists should be available in hemodialysis units to provide care of psychological aspect of children .