Background: Pediatric data on the epidemiology of acute kidney injury (AKI) in acute myeloid leukemia (AML) are limited, although the incidence of AKI appears to be very high in this patient group. The aim of this study was to assess the prevalence of and factors associated with AKI in childhood AML during chemotherapy treatment. Materials and methods: The medical records of 112 children aged under 15 years diagnosed with AML who received chemotherapy in a major tertiary care referral center in Southern Thailand were reviewed. Logistic regression was used to identify factors associated with AKI. Results: Fifty-six (50%) children had 69 AKI events. The median time from AML diagnosis to the first AKI was 29.5 days (interquartile range: 11.0-92.8). Age at diagnosis ≥ 10 years (OR 2.75, 95% CI 1.09-6.93), glomerular filtration rate < 90 mL/min/1.73 m2 at AML diagnosis (OR 7.58, 95% CI 1.89-30.5) and septic shock (OR 22.0, 95% CI 4.63-104.3) were independently associated with AKI. Conclusions: Childhood AML has a high rate of renal injury with 50% having AKI. Age ≥ 10 years at diagnosis, impaired renal function before treatment, and septic shock were strongly associated with AKI.