We present the incidence, management and outcome of acute renal failure (ARF) in children who underwent cardiac surgery. Fourteen (9%) from a total of 156 children developed ARF in our hospital in a 3-year period. Patients were aged 2 days to 15 years. Prerenal failure was present in 6 and renal type in the remaining 8 children. Peritoneal dialysis treatment was utilized in 58% of patients. Neurologic and respiratory complications were present. Mortality rate was 58% and related to underlying pathology and to complications in other organs. The management of these patients must be by competent personnel preferably trained in pediatrics.