Acute kidney injury is an independent risk factor for mortality in sick newborns. The aim of the current study was to evaluate the risk factors, etiology and outcome of cases of acute kidney injury, by using a retrospective study of neonates who were admitted at Cairo University hospital NICUS during the period of ( 2009-2011).The study revealed that the main risk factors for AKI are prematurity (39.7%),dehydration (36.5%) followed by sepsis (34.9%).Sixty three neonate out of 3042 neonates who fulfilled criteria of AKI. The main cause of death in AKI cases was combination of sepsis and dehydration (34%).