Uremic encephalopathy (UE) is a clinical syndrome that was frequently seen in patients with end stage renal disease. Pathophysiology is multifactorial and partially characterised. Patients may have symptoms ranging from mild sensorial clouding to coma. Because of those, clinical symptoms like disorder of consantration, decrease in attention span, unwillingness and debility which may be seen on early stage couldn't realised by the patient's family or the clinician or was thought to be the clinical features of the primary disease. With renal transplantation and advanced dialysis techniques UE becomes less frequent but also different clinical features present as a problem. For these reasons, good cooperation between nephrologists and neurologists who care for these patients are important. This article consantrates on recent developments in pathophisyology, clinics, diagnosis and differential diagnosis of UE.