Introduction: Severe hypoxic ischemic organ damage is caused by asphyxia in newborns which can follow fatal outcomes or severe life-long pathologies like renal insufficiency. We wanted to note the frequency of renal derangement in neonates having asphyxia neonatoum in this study. Setting & Period: Department of Pediatrics, Bahawal Victoria Hospital (BVH), Bahawalpur, from 1st January 2017 to 31st June 2017. Materials & Methods: Two hundred and sixty four neonates of both genders with birth asphyxia were included in the study. Main outcome was renal derangement in asphyxia neonatorum. Results: Mean weight was 2.54 kg with standard deviation 0.50 kg and having mean APGAR score 4.43 with SD 1.66. 0It was noted that 189 (71.6%) neonates had Renal derangement in which 109 (57.7%) were males and 80 (42.3%) were females with mean of weight was 2.53kg, having mean APGAR score 4.44. Conclusion: Renal derangement is quite common in neonates with birth asphyxia.