Wilms’ tumour is the most common among renal tumours in the paediatric population. In Africa, data on pediatric renal tumours are rare. This study aims to highlight the challenges and peculiarities in the management of paediatric renal tumours in a resource-poor setting. Materials and Methods This is a five-year retrospective study conducted at the University of Port Harcourt Teaching Hospital. Ethical approval for the study was sought and gotten from the hospital’s ethical committee. The information gotten includes history, duration of symptoms, examination findings, age of the patient, stage of disease, intraoperative findings, number of chemotherapies, and post-operative complications. The data collected was analyzed and presented in tables and charts. Results: Twenty-eight patients met the inclusion criteria; 17 males and 11 females. The mean age was 3 years 6 months and the median age was 3 years 3 months. The age range was 9 months to 16 years. Most patients presented between 3 and 9 months after the onset of symptoms. The most common symptom was a painless abdominal mass which was present in all patients. Most patients presented late as fifty percent of patients presented with Stage 4 disease. Most patients had nephrectomy followed by adjuvant chemotherapy. Only three patients are alive five years after treatment. Conclusion: Mean age of presentation of patients with pediatric renal tumours was 3.5years. Late presentation with advanced stage is common. Painless abdominal mass was the most common presentation. The most common histological diagnosis was Wilm’s tumour. We carried out a nephrectomy before adjuvant chemotherapy or radiotherapy.