Introduction One of the frequent neurological complications of end stage kidney disease (ESKD) is uremic peripheral neuropathy (UPNP). A rapidly expanding literature on the relationship between 25(OH) vitamin D and UPNP shows a high link between them. Interleukin 10(IL-10) reduced level may contributes to UPNP. The aim was to assess the correlation between serum levels of vitamin D and IL-10 with the incidence of UPNP in children on regular hemodialysis. Methods A cross-sectional study included 71 children on regular hemodialysis, aged between 3 and 18 years. They were sub classified into two groups after assessment with nerve conduction studies (NCS) and neuropathy score; group I consisted of 24 patients with PNP and group II consisted of 47 patients without PNP. All patients were subjected to clinical examination, laboratory investigations and serum 25(OH) vitamin D and IL-10. Results Patients with PNP had significantly lower serum levels of IL-10 (P<0.001**) and 25(OH) vitamin D (P=0.003*) than those without PNP. 70% of patients with PNP had vitamin D deficiency with statistically significant difference (P < 0.001). The serum levels of 25(OH) vitamin D and IL-10 have a statistically significant negative correlation with severity of UPNP. There was a significant positive correlation between IL-10 and vitamin D levels (P= 0.022). Longer duration of dialysis with age more than 11 years, low vitamin D, and low IL-10 were independent variables for UPNP. Conclusions Low vitamin D and IL-10 levels increase the risk of PNP in children on hemodialysis