Background: Acute kidney injury (AKI) is a serious postoperative complication after cardiac surgery and is a major contributor to patient outcome. This study aims to identify the predictors of early AKI in children undergoing cardiac surgery in limited resource setting. Materials and Methods: 49 children undergoing cardiac surgery for congenital heart disease were included. Plasma creatinine and urine output were recorded to identify AKI based on the pRIFLE and AKIN criteria. The patients’ demographic data, type of surgery, medications and hemodynamic parameters were analyzed for predictors of AKI. Results: AKI occurred in 73.4% of children ages 24 30.7 months. Low cardiac output state, cardiopulmonary arrest, average daily inotropic score, average daily dose of furosemide and fluid overload in the postoperative period were associated with development of AKI. There was increase in the duration of mechanical ventilation and mortality in patients who developed AKI stage III. Conclusion: AKI is common among children undergoing moderate complexity cardiac surgery for congenital heart disease in a limited resource health care setting. AKI is associated with significantly higher morbidity, mortality, healthcare utilization and costs.