Background: Chronic renal failure is a worldwide health problem, with increasing prevalence and adverse outcomes. Children's nutritional status reflects the degree to which physiologic needs for nutrients are being met. In challenges of pediatric nurse role, she must gathering data for nutrition assessment, provide education regarding dietary modifications, encourage appropriate food choice, and evaluate the adequacy of nutrient intake for children with CRF as they are already in risk for poor nutritional health. Aim of the study was to assess the nutritional status of the school age children with CRF undergoing hemodialysis. Setting it was carried out in hemodialysis unit of Alexandria University Children at El-Shatby Hospital (AUCH) and Health Insurance Student's Hospital (HISH) in Alexandria, Egypt. Subject: A convenient sample of all children (30) with chronic renal failure undergoing hemodialysis was involved. Materials and Method: A structured interview questionnaire was designed and used to interview the child or mothers. It included nutritional assessment of studied children such as Physical examination, anthropometric measurements and lab investigation. The results revealed that the majority of studied children had height, weight, BMI, MAC, TSFT less than normal. The majority of children were anemic. Most of children had low in vitamins such as A (93.3%), C (93.3%) and D (100%). 63.3 % of the studied children had hypoalbuminaemia. high percent of children had hypocalcemia and hypokalemia. All of studied children had hypercreatinemia. Recommendation: nutritional counseling should be performed based on individualized assessment of children with consideration of the children age, development, food preference, activity, cultural beliefs, and psychological status.