This study of 150 patients suffering from acute renal failure (ARF) showed that the cause was medical in 98 patients, gynaecological in 26, surgical in 15 and obstetric in 11. In contrast to the findings of similar studies in Europe and the USA, the commonest medical causes of acute renal failure were nephrotoxins (mainly from herbal medicine) and infections. The commonest gynaecological cause of ARF was self-induced abortion. The relevant clinical and biochemical features are described. The overall mortality was 35%. Adverse factors affecting prognosis were septicaemia, jaundice, the cause of the ARF, and delay in beginning dialysis. While financial costs may prohibit the establishment of renal units for the treatment of chronic renal failure in many parts of Africa, ARF may easily be treated.