Abstract: End-stage Renal Disease (ESRD) is the terminal state of the kidney when its function has been permanently and irreversibly damaged. Renin-angiotensin System (RAS) has been considered to be responsible for the pathogenesis and progression of kidney diseases. This study aimed to determine the association between genetic polymorphism of the three members of RAS system, Angiotensin-converting Enzyme (ACE), Angiotensinogen (AGT) and Angiotensin II type 1 receptor (AT1R) and the development of ESRD and their relation with disease progression. The study included 330 subjects who were classified into 2 groups. GroupI:180 patients with ESRD on maintenance haemodialysis and Group II:150 healthy controls. All individuals underwent genotyping for ACE I/D polymorphism, AGT (M235T) polymorphism and AT1R (A1166C) polymorphism using (RFLP).Genotype distribution of both ACE I/D and AGT (M235T) polymorphisms showed significant statistical difference between ESRD patients and controls. DD genotype of ACE gene polymorphism was associated with 3.3 fold increased risk for ESRD (95% CI: 1.9-5.8) and TT genotype of AGT (M235T)polymorphism was associated with 2.5 fold increased risk for ESRD (95% CI: 1.5-4.1). However CC genotype of AT1R had 2.6 fold increased risk for development of ESRD (95% CI: 1.3-5.2).TT genotype of AGT, DD genotype of ACE and CC genotype of AT1R polymorphism had a strong positive relation with disease progression with the shortest time needed for the start of dialysis compared to other genotypes. A significant association between ACE I/D polymorphism, AGT (M235T) polymorphism and both the development of ESRD and rate of disease progression.