AKI is common among hospitalized neonates and children and associated with adverse short- and long-term kidney outcomes. However, data for long-term outcomes of children with episodes of dialysis-treated AKI are limited. Using Ontario provincial health administrative databases, the authors identified 1688 pediatric survivors hospitalized and treated with dialysis for AKI episodes in 1996–2017, and followed them for a median of 9.6 years. Compared with matched hospitalized comparators, AKI survivors were at significantly increased risk of long-term kidney failure or death. The authors also observed significantly higher long-term rates of CKD and hypertension among the dialysis-treated AKI survivors. These findings support enhanced surveillance of kidney function and blood pressure after episodes of severe childhood AKI, with the aim of improving long-term kidney and patient survival.