Acute renal failure (ARF) is defined as a significant acute decline in glomerular filtration rate (GFR), usually associated with uraemia, which may or may not be associated with a fall in urine output. It is a frequent complication in critically ill patients and associated with an excess mortality. In fact, ARF is nowadays mostly observed as part of the multi-organ dysfunction syndrome in severe sepsis and septic shock. [7] Hence based on above findings the present study was planned for Evaluation of Factors Responsible for Acute Renal Failure in Septicemic Neonates from Bihar Region. The present study was planned in Department of Pediatrics, Mata Gujri Memorial Medical College and Lions Seva Kendra Hospital, Kishanganj, Bihar, India. In the present study 100 cases of neonates diagnosed with the neonatal sepsis were enrolled in the present study. Out of that 28 cases were diagnosed with the Acute Renal Failure (ARF) were evaluated and discussed with the already reported literature. Risk factors evaluated for fatality in sepsis associated ARF included gestational age, weight, early onset, culture positivity, associated meningitis, asphyxia, shock, administration of nephrotoxic drugs and presence of oliguria. The data generated from the present study concludes that ARF is a very common entity among septic neonates. Low birth weight is an important risk factor for the development of ARF in septic neonates. The latent period for the development of ARF in neonatal sepsis is short. The high mortality among septic neonates with ARF stresses the need for septic neonates to be screened for renal failure