Background: IE is not an easily treated disease. Renal involvement commonly occur in IE patients, and are usually multifactorial. Patients can develop different forms of renal involvement. A variety of organisms may be involved in those developing this involvement, with the most common being S. aureus. Renal involvement is associated with an increased risk of mortality. Objectives: The aim of this study is to determine the prevalence and the predictors of renal involvement in IE patients treated in single tertiary care center in Egypt. Patients and methods: The study involved 144 patients admitted at Cairo University Hospitals during the period from 2/2005 to 10/2008 with definite/possible IE according to the modified Duke criteria for the diagnosis of IE. The data of hospital admission were analyzed retrospectively. Results: The prevalence of renal involvement in IE patients in our study was 71.6%. Males were more common than females (52.1% versus 47.9%). The most common organism was S. aureus (21.8%). Predictors of renal involvement were age (p= 0.003), diabetes mellitus (p=0.04), hospitalization within last 3 month (p= 0.01), heart failure (p= 0.01), leukocytosis (p= 0.02), anemia (p= 0.001) and vancomycin (p=0.04). Renal failure occurred in 26.9% and dialysis was required in 5.2% of patients as a consequence of their renal impairment. Mortality rate of patients who developed renal involvement in IE was high, it represented 46.9%. Conclusion: Heart failure, leukocytosis and anemia, the presence of S. aureus, and vancomycin used in IE treatment are all useful predictors of renal involvement.