Introduction: Acute kidney injury (AKI) is a common clinical problem in intensive care unit (ICU) patients and independently predicts poor outcome.1 Recently, two large multi-centre cohort studies reported the occurrence of AKI in an estimated 36% of all patients admitted to the ICU2. Moreover, additional observational data indicate that the incidence of AKI is rising.3,4 Aims and Objectives: Analysis of the clinical spectrum and laboratory findings of AKI patients in ICU, identify the cause, risk and prognostic factors for AKI and analyzing the final outcome of the patients with AKI. Material and Methods:Fifty patients with abnormal kidney size, abnormal cortico medullary differentiation and an absolute increase of Creatinine more than 1 to5 fold from the base line were included in the study. A thorough diagnostic evaluation by a detailed history, physical examination, urine analysis, complete blood picture (CBC), renal function test (RFT) and renal ultrasonography (USG) was recorded. Results:Among the fifty patients with suspected AKI, ratio of oliguria and non oliguria patients was 4:1. Out of 10 non oliguria cases, one is snake bite, four poisoning, 2 acute diarrheal disease and 3 sepsis cases. The age group included 13-85 yrs with mean age group of 38.26 yrs. Conservative treatment given to 24 while 26 were kept on dialysis. Recovery was 90% in risk, 91.7% in injury cases while 61.1% among failure cases. Mortality was 20% among the study group. Conclusion:AKI is usually asymptomatic and diagnosed when biochemical monitoring of hospitalized patients reveal a new increase in blood urea and serum Creatinine concentration. As the clinical and biochemical parameters indicate AKI, prompt treatment with Renal Replacement Therapy (RRT) helps in decreasing the morbidity & mortality.