Growth failure is a common and significant clinical problem in children with chronic renal failure. This study was carried out to assess growth and nutritional status in 30 Egyptian children with ESRD on regular hemodialysis at the Hemodialysis Unit of the Center of Pediatric Nephrology and Transplantation of Cairo University. Their age ranged from 6.41-13.83 years with a mean of 10.5 years. Results revealed that there is a significant growth retardation in these children as 83.3 % of these children were short (mean Ht. SDS > -2), and the mean height SDS was -3.66. This retardation was significantly related to duration of the disease, degree of anemia, degree of metabolic acidosis, renal osteodystrophy, and caloric and protein intake. Treatment of these factors is essential to improve growth and should be considered before GH therapy.