Background: Chronic kidney disease is defined as abnormality of urinary system, there is persistent abnormality of structure and upward renal excretory function that is sign of irreversible damage to function of nephron. It is a public health problem world widely and it is 12th most common cause of mortality and morbidity, respectively. Objective: To evaluate chronic kidney disease (CKD) sonographically in addition correlating echogenicity with the level of serum creatinine. Study Design: An analytical Cross sectional prospective study. Settings: Life Care Hospital, Radiology department Lahore. Period: 20th December 2020 till 10th April 2021. Material & Methods: In our study all those patients with age above 18, patients suffering from chronic kidney disease, patient on hemodialysis, diabetic and hypertensive were included. While patient below 18 age, patients on peritoneal dialysis were excluded in which 71 patients were enrolled in the research. All the patient’s data had been composed from indoor of hospital, outdoor of hospital, and emergency department of Life Care Hospital, Lahore. After informed consent, data was composed through ultrasound machine Toshiba Xario Prime. Results: The findings revealed that there were 71 Chronic Renal Failure patients, 45 of whom were male and 26 of whom were female, with ages ranging from 20 to 73. Since the P value is > 0.05 of the relevance indicators, there is no important relationship between the two variables. Conclusion: The ideal sonographic parameter that can be used to correlate the level of serum creatinine with kidney parameter within ultrasound is kidney cortical echogenicity. As kidney cortical echogenicity does not reverses as the disease progress even after the treatment, so it is the most accurate parameter that can be used. Keywords: Chronic kidney disease, Echogenicity grade, Serum creatinine, Ultrasound, estimated Glomerular Filtration rate. DOI: 10.7176/JHMN/90-05 Publication date:June 30th 202