Background: chronic kidney disease means lasting damage to the kidney that can get worse over time. Chronic kidney disease is more prevalent in the elderly population, however younger population show progressive loss of kidney function. It’s widespread and often goes undiagnosed until the disease is well advanced. Objectives: To determine the epidemiology, aetiological factors, outcomes among patients with chronic renal failure. Methods: A retrospective study was performed on patients with chronic renal failure admitted to Al-Ramadi Teaching Hospital, during the period between January1 to December 31, 2008. A total of 250 patients 127 male and 123 female who was admitted to the medical floor and the haemodialysis unit, constituted the study group. Results: There were (50.8%) males patients and (49.2%) females patients. The mean age of the study patients was (47.58) years. The most frequent age group was (46-60) years with frequency of (29.6%). The prevalence of various causes of chronic renal failure in this study was: diabetes mellitus: (30.8%), hypertension: (23.2%), obstructive uropathy: (16.4%), glomerulonephritis: (4.8%), adult polycystic kidney diseases: (4%), interstitial nephritis (drug induced): (3.2%), pyelonephritis: (2.8%), multiple myeloma: (0.8%) and unknown causes: (14%) of the patients. Conclusions: The incidence of chronic renal failure is high in Al-Anbar province. Occurrence of the disease in urban population more than in rural one. Case _fatality rate was high in our governorate. A cardiovascular disease was the leading causes of death fallowed by cerebrovascular accidents.