Children and adolescents with end stage renal disease (ESRD) require life-long treatment. The purpose of this descriptive investigation was to identify coping strategies that adolescents with ESRD use to manage their chronic illness. Participants for this investigation were 35 adolescents, 13-18 years of age, with ESRD. The A-COPE survey instrument was used in a clinical and camp setting to measure the coping strategies used by adolescents with ESRD. Analyses revealed that adolescents with ESRD utilized a variety of coping strategies to manage the stresses of living with their chronic condition. Personal characteristics of gender, transplant status, age, and religious views were significantly related to the coping strategies the adolescents reported using.