The outcome of children with kidney tumors has significantly improved in the last two decades in the developed world but not in resource poor countries. We share our ten years experience from a single institution of Pakistan. Records of 23 children with kidney tumors were reviewed for demographics, presenting features, staging work-up and outcome. There were 21 (91%) children with Wilms tumor and one each of clear cell sarcoma of kidney and rhabdoid tumor of kidney. Median age of presentation was 4 years with male predominance. Abdominal mass was the commonest presenting feature. Advanced stage was seen in 17 (74%) patients. Eighteen children agreed for therapy and were treated according to National Wilms Tumor Study Guidelines. The overall relapse free survival for children with Wilms Tumor was 56%. Both children with other histopathological subtypes died. Further improvement in survival of these children can only be achieved by increasing awareness, early recognition, appropriate referral, and multidisciplinary approach. [Turk J Cancer 2009;39(1):131-135]