Abstract Background: the survival of Wilms tumor is very low when evaluated in 2008. The impact of establishing pediatric oncology service on survival is studied, and the obstacles of treating Wilms tumor patients were identified. Procedure: All Wilms tumor patients from 2005 to 2014 were analyzed retrospectively. Patients received treatment based on the NWTS IV protocol. Patients were analyzed for overall survival, and event-free survival, and these outcomes were correlated with age, sex, stage at presentation, and histology. Results: We analyzed 143 files of Wilms tumor. The male to female ratio is 1.75. The mean age of patients at diagnosis is 3.5. The follow-up period is five years. Most patients (83%) had advanced disease stage 3, and 4.There is a very high abandonment rate (37%). The event-free survival among patients who completed treatment is 75.6%, and the overall survival is 43.4% Conclusions: There is a remarkable improvement in Wilms tumor survival from 11% to 43 % and 75.6%. Much needs to be done to reduce abandonment rates and establish a surgical pediatric oncology service.