Egypt is a developing country and renal transplantation in children lagging tremendously. The aim of the study was to assess the difficulties against renal transplantation in Egyptian children and the attitudes of the families in Egyptian children towards such a treatment option. The study included 56 children and young adults, the families and children were interviewed and their records analyzed. Conclusion: There are many difficulties against successful renal transplantation program for children with end stage renal disease in Egypt. The government and health authorities must adress such issues and offer effective assistance to such families to increase awareness and facilitate such a treatment option