Background: Children with chronic renal failure have an increased risk of mortality due to cardiovascular problems. Objective: To evaluation ofcardiac complications using conventional echocardiography among children with end stage renal disease. Subject and Methods: This study was conducted on 40 children with chronic renal failure (17 males and 23 females), their age ranged from 8 years to 17 years, attending the Nephrology Unit of the Pediatric Hospital Zagazig University. All children were subjected to thorough history taking, complete detailed clinical examination and laboratory investigations. All cases and control were assessed by conventional echocardiography. Results: using mitral and tricuspid inflow velocities peak early velocity (E), peak late velocity (A), E/A ratio, we found significant decreased E/A ratio in our cases predialysis than control group of both mitral and tricuspid inflow velocities; the E/A ratio of the mitral and tricuspid valves dropped considerably following dialysis, which has been linked to diminished compliance of the ventricle due to hypertrophy. Myocardial performance index (MPI) assessing global systolic and diastolic functions of both RV and LV showed statistically significant increased values in cases more than control but did not show significant difference after dialysis. Conclusion: Major cardiac abnormalities are present in children with chronic renal failure (CRF), and they likely contribute to the high cardiovascular death rate seen in this population.