Addison disease is a rare endocrine disorder in which the body produces insufficient amounts of adrenal steroid hormones. In this study, Clinical and laboratory data of thirty Addisonian patients following up at the Diabetic Endocrine Metabolic Pediatric Unit (DEMPU) in Al Monira University Children Hospital & CSPM, are retrospectively studied in order to define the most common etiology, age of presentation, mode of presentation, and assess their treatment and growth pattern, with emphasis on; etiology, age of presentation, mode of presentation, relevant family history, laboratory investigations, imaging studies, anthropometric measures , type and dose of treatment along different visits. The results of the study showed that, the mean age of presentation was 6.722 years. Of the thirty patients; 20% were diagnosed as triple A syndrome and 10% were diagnosed as ALD. TB caused the adrenal insufficiency in 6.66% of the patients, while autoimmune adrenalitis was the cause of Addison disease in one patient. 60% of the patients remained of undiagnosed etiology. The mode of presentation included hyperpigmentation, vomiting, diarrhea, wt loss, failure to thrive, weakness, and drowsiness. Consanguinity was positive in 76.67% of the patients. Our results demonstrate that, inherited conditions were common causes of adrenal insufficiency in our study, high prevalence of positive consanguinity in Egypt is major contributing factor. Hyperpigmentation and vomiting were the most common clinical features at presentation, and after several years of treatment 40% of the patients are still below the 3rd percentile of growth while 60% are above it.