Early detection and proper management of acute graft dysfunction particularly acute rejection (AR) to improve outcomes are still needed. Urinary CXCL10 chemokine could provide a non-invasive monitoring marker for graft function. The aim of this study is to investigate the association of urinary CXCL10 levels with AR and to evaluate its prognostic value and utility as follow up marker after antirejection treatment. Methods: Data of ninety-seven transplanted children was obtained and analyzed. Urine samples for CXCL 10 testing by ELISA technique were obtained from all patients. Follow up CXCL 10 evaluation for recipients with AR was performed one month later.