Chronic renal failure is a common clinical condition among patients attending hospitals in Nigeria as in other parts of the world. From hospital admission records, the prevalence of CRF was 8% in Ile – Ife and 7.3% in Ibadan. Chronic renal failure presents with an array of skin problems. These skin problems contribute to morbidity and mortality in patients with CRF and hence should not be over looked. The skin problems may arise directly as a result of the kidney impairment, from the underlying disorder causing the kidney impairment or they may be related to treatment. Various studies have been carried out in Caucasians that looked into the skin manifestation of CRF. There is however paucity of published works on skin manifestations of CRF in Nigeria patients. This study intended to add to the information available on the skin manifestation of CRF. AIMS AND OBJECTIVES The aims and objectives of the study were; 1. To determine the prevalence of skin manifestations in patients with chronic renal failure in Ibadan. 2. To describe the pattern of the manifestations in these patients. 3. To highlight the peculiarities of the skin disorders seen in these patients compared to what has been documented in other parts of the world. METHODOLOGY One hundred and twenty patients with CRF were chosen consecutively with an equal number of age and sex matched controls. Selection of CRF patients was done after review of creatinine clearance and other results. Controls had normal creatinine clearance. Thorough examination of each patient was carried out and findings documented and analyzed. RESULTS The prevalence of skin manifestations was 89.1% among the CRF patients. Xerosis was the most common skin manifestation among the patients with CRF with 60% of them having xerosis. Half and half nails and pruritus followed this with prevalence of 40% and 26.7% respectively. The patients managed with haemodialysis were found to have a higher tendency to having xerosis. Pruritus, xerosis and half and half nails and ichthyosis were significantly more common in CRF patients than controls while acneiform eruptions were more common among the controls. CONCLUSION Skin manifestations are common among Nigerian CRF patients. Skin problems like xerosis, half and half nails and pruritus may serve as pointers to underlying kidney disease and their presence should heighten the suspicion of a possible kidney disease. Investigations should therefore be carried out in such instances to exclude CRF where these conditions are found especially when no ready explanation for their presence can be given