This study was performed to evaluate hospital-acquired renal insufficiency with special reference to the causative factors, clinical course and patient management. A total of 100 patients who were admitted to medical and surgical wards at the King Hussein Medical Center, Amman, Jordan over a 15-month period and who developed renal failure during their hospital stay, were referred to, and seen at the nephrology department. The patients ages varied from 18 to 77 years; there were 59 males and 41 females. Reduced renal perfusion, major surgery and administration of nephrotoxic drugs accounted for the majority of episodes of renal failure (77%). In general, non-oliguric patients fared better, they required dialysis less frequently and had lower mortality compared to the oliguric patients. Severity of renal failure and multi-organ involvement adversely affected the prognosis. However, age of the patient had no influence on the outcome.