Aim: To evaluate left ventricular (LV) diastolic function in children with end-stage renal disease ( ESRD) using conventional pulsed-Doppler echocardiography and Doppler tissue imaging (DTI), and to compare the findings with these two modalities. Methods: Twenty-four children with ESRD and 22 healthy age- and sex-matched control subjects were assessed with conventional Doppler echocardiography and DTI. The scans of the renal disease patients were done after a dialysis session. Parameters related to LV systolic and diastolic function were compared in the ESRD and control groups. Results: The ESRD patients had lower mean mitral E/A ratio both according to conventional Doppler echocardiography and TDI than the control subjects. The ESRD group also had significantly longer isovolumetric relaxation time (116 +/- 31 ms vs 97 +/- 3.1 ms, respectively; p<0.001), and significantly longer deceleration time (235 +/- 44 ms vs 202 +/- 35 ms, respectively; p<0.01) than the control group.