Context: An understanding of epidemiology of AKI is necessary in order to establish it’s over all burden. Aims: To study aetiology and prognostic markers to improve survival and to plan potential preventive strategies in the management of AKI. Settings and Design: Secondary care hospital, retrospective analysis. Methods and Material: Case record analysis done in 300 consecutive cases of AKI admitted to Tata Main Hospital from January 2013 to February 2014. Statistical analysis used: Odds Ratio and Relative Risk. Results: AKI involves relatively younger and healthy individuals with mean age of 44.5 years. The commonest cause of AKI was medical diseases (75%), followed by surgical (20%), and obstetric cases (5%). Amongst the medical causes, commonest was Falciparum malaria (36%), followed by acute diarrhoeal diseases (33.3%) and Sepsis (13.3%). Amongst the surgical causes, commonest was acute pancreatitis (33.3%), followed by obstructive uropathy (17%), burn injury (16.6%), abdominal sepsis (11.7%) and poly-trauma (11.6%). Overall mortality of AKI was 20%. Bad prognostic markers were multi-organ failure (>= 4 organ), surgical AKI and oliguria, associated with higher mortality. Favourable prognostic markers were medical causes of AKI, non-oliguric AKI and up to 3 organ failure. Conclusions: Acute Kidney Injury is largely a preventable and community acquired condition, sepsis being the main contributory factor. It is associated with increased LOS, increased risk of death, increased cost to hospital, and mortality rate of >50% in critically ill.