Background: Chronic Kidney disease (CKD) is a major public health problem worldwide. Causes of CKD are very different in children from those in adult. Congenital abnormalities of the kidney and urinary tract are the main cause of CKD in children. The objectives of this study are to determine the etiology and outcome of CKD in Libyan children at Tripoli Children Hospital. Patients and methods: Across sectional study included of 162 Libyan children with evidence of CKD, who followed up in nephrology unit at Tripoli Children Hospital from the year 2001 to 2021.CKD were defined and grading according to Kidney Disease Improving Global Outcomes (KDIGO) guidelines. Results: there, 56.8% of cases were less than 5 years, 59.3% of cases were males and male to female ratio was 1.45; with mean age of 11.4 years. The underlining causes of CKD in children were: Glomerulonephritis (14.8%), FSGS were the main cause of glomerulonephritis; hereditary nephropathy (17.3%) PH1were commonest cause of it; Congenital anomalies of kidney and urinary tract (CAKUT) (57.4%), PUV accounted for the most common underlining cause of congenital anomalies. The outcomes of these children, 30.4% was still follow up with CKD, 24.1% of cases reached end stage renal disease (ESRD), 8.6% of them were died and 16% of cases were missed follow up. Conclusion: The most common cause of CKD of these children were CAKUT with late presentation to pediatric nephrologist. Children who were at risk, need proper followed up and early conservative treatment to prevent the progression of CKD.