Wilm's tumor is the most common malignant renal tumor in children represents 6% of childhood cancers. WT presented by abdominal mass, loss of weight, anemia, hypertension. Aim of the work is to compare the effect of preoperative chemotherapy versus the standard up front surgical resection. Results of this study revealed that in group I: Resectability of the tumor in 19 child versus one child is highly significant. Down staging in group I is highly significant