Background: Therapeutic plasma exchange (TPE) or plasmapheresis is a procedure which removes circulating antibodies, immune complexes and toxins from the blood. TPE has been successfully used in various pediatric immunological and non-immunological diseases. Aim of the study: This work aims to study the outcome of therapeutic plasma exchange in our University Hospitals. Methods: This is a descriptive study, carried out in a one year including patients who were treated using TPE; clinical data, number of sessions, volume of plasma exchanged, outcomes and complications were recorded and statistically analyzed. Results: Thirty six patients were included in this study; 13 patients had Guillain Barre Syndrome (GBS), 9 patients had hemolytic uremic syndrome (HUS), 9 patients had nephrotic syndrome, 3 patients had Amyloidosis, and 2 patients had Systemic lupus erythematosus (SLE). Throughout this year we delivered 301 session of TPE , As regard complications; the most common complication was hypofibrinogenemia, Twenty seven patients experienced improvement and 6 patients showed no improvement while 3 patients died during the course of disease treatment. Conclusion: Therapeutic plasma exchange is a safe and effective adjuvant therapy for many diseases especially autoimmune diseases.