We aimed to describe pediatric stroke in dialysis children and the difficulty of managing stroke during the dialysis session. Our retrospective study collected data from cerebral ischemic attacks (CIA), cerebral hemorrhage (CH) over a period of 3 years (2003–2016) among dialysis children. Patients were monitored during the dialysis session to monitor CF, SPIO2, blood pressure with a therapeutic blood pressure goal of 150/100 mm Hg. Nine patients, 5 girls and 4 boys, average of 8 years old. Three patients had a neurological form of hemolytic uremic syndrome, 2 patients had a scleroderma crisis complicated by malignant hypertension, 2 dialysis patients with malignant nephro-angiosclerosis received an anticoagulant overdose, 2 patients with poorly controlled hypertension had reflux nephropathy. Upon admission, arterial hypertension was found in all patients average systolic pressure: 175 mmHg [140–190] and diastolic pressure: 115 mmHg [95–120]. Neurological clinical syndromes as: headache, visual blur and ear buzz (3 cases), 1 patient with right hemiplegia had aphasia without disturbances of consciousness, and 1 had hemiplegia with deviation of the head to the left. The convulsions were observed in 3 patients, coma in 1 patient. Brain imaging revealed 5 cases of CIA and 4 cases CH. In addition to treatment with extra-renal cleansing without heparinization, patients were treated by (captopril); and anticonvulsants.2 children died after (extensive brain hemorrhage) 1 month after the stroke. For one patient, a decrease in hemiparesis was observed with persistent facial asymmetry and a preferential grip on the right in another child. Cause or consequences of the renal disease, HT must be properly treated in order to reach the recommended targeted blood pressure values. The time required to take charge the hypertensive stroke determines the prognosis. The challenge is to optimize the health care sector to reduce mortality and sequelae.