Introduction: Children with vitamin D deficiency require treatment to prevent hypocalcaemia and bone deformity . Oral supplementation is generally recommended. However, adherence and timing could be a challenge with multiple medications in children with renal disease, prompting Intramuscular vitamin D (IMD) to be a practical alternative. Objective: To evaluate the safety and efficacy of intramuscular vitamin D injections (IMD) in children with renal disease Methodology: The retrospective longitudinal study included children attending Paediatric Nephrology Clinic at National Hospital, Galle, who received IMD between July ,2024 to July ,2025. Vitamin D levels were reassessed 4 months after injection. Results: Eighty children (mean age 10.2±4.1 years) received IMD; 49(61.3%) were male. Before injections 42.5% were deficient and 57 .5% were insufficient. Post-injection, 86% achieved sufficient levels with no cases of deficiency or toxicity . Age and body mass index (BMI) were significant predictors of post level. A paired sample t-test showed a significant increase in levels from pre-injection (M=50.7 ,SD=16.8) to post-injection (M=114.3,SD=34.5); r (79) =14.8, p