Background: Cardiovascular disease (CVD) accounts for the majority of deaths in children with chronic kidney disease (CKD) and post renal transplant. The aim of this thesis was to study the prevalence of the different cardiovascular risk factors in patients, trying to determine the best modality for cardiovascular assessment of this particular group of patients and to highlight other associated significant risk factors for poor cardiac performance in these patients.Methods: The study included 30 pediatric renal transplant recipients and 10 as control. The LV function has been evaluated using conventional 2D, M mode echocardiography, pulsed Doppler and tissue Doppler imaging. Results: prevalence of left ventricular hypertrophy was 93.3% there was a statistically significant positive correlation between LVMI and E/E' ratio (P=0.032) left ventricular hypertrophy was associated with diastolic dysfunction the Mean E/E' in hypertensive cases (8.03±1.15) was significantly higher than mean E/E' in the non hypertensive cases (6.35±0.86) (P<0.001), where the mean E/E' was affected by diastolic blood pressure (P<0.001) than systolic blood pressure. Also we were evaluating the associated risk factors like hypertension, anemia and hypercholesterolemia.Conclusion: Diastolic dysfunction and chamber abnormality are present even post transplantation so regular echocardiographic follows up is recommended and TDI appears to be more impressive than cPWD in assessing early myocardial dysfunction.