Introduction: Hyperuricemia is considered a putative risk factor for the progression of renal disease and febuxostat is used as an additional therapy for the control of lowering eGFRin CKD 3 and 4 patients. Objective: To determine the effect of febuxostat on eGFR among patients with chronic renal failure and increased uric acid levels. Materials and Methods: A single-Blind, RCT was conducted at Mayo Hospital, Lahore from 1st February 2019 to 31st January 2020. 330 Patients who full filled the inclusion criteria were enrolled. After the approval from Ethical Committee, written informed consent was taken and they were randomly divided into 2 groups. Group A patients received febuxostat 40 mg daily and group B received a placebo with conventional therapy. Patients were evaluated for mean eGFR at the start, 3 and 6 months of treatment in both groups. Data was entered and analyzed in SPSS ver: 21. Mean and standard deviation were calculated for numerical variables. An Independent test was used to compare the means between the groups at baseline, 3 and 6 months with p __ampersandsignlt; .05 as statistical significant. Results: In this study, efficacy was determined in terms of retardation in eGFR decline. At baseline and at 3rd month, no significant difference was found in eGFR in both groups however at 6th month mean eGFR was higher in Group A as compared to group B. Conclusion: The study concluded that febuxostat is more efficacious in the slowing of declining e-GFR in patients with CKD stage 3 and 4.