Today most of patients with chronic disease can be treated; therefore many studied in this field have focused on psychosocial problems. This descriptive study aimed to determine and compare the Self-Esteem level and optimism of patients with chronic renal failure and leukemia participants. Subjects and methods: The studied was conducted at the out patient and hematology department of Upper Egypt Cancer Institution, and kidney dialysis unit at Assiut University Hospital. The subjects were comprised from 1oo adult patients and fulfilling the following criteria: age18 to 65 years, diagnosed as chronic renal failure and leukemia, and accepted to participate in the study, their number amounted to 50 chronic renal failures patients and 50 leukemia patients which were selected randomly. Data was collected using an interview schedule for assessing socio demographic data. The Optimism and self-esteem Scale (Developed by Taha – Al-Mestekawy2007): was use to assess the level of the optimism and self –esteem of the tow group of patients. Results: The results reveled that, the mean scores of self- esteem and optimism were high in the chronic renal failure and low in the leukemia patients. Conclusion: The study concluded that adult patients with chronic renal failure and leukemia have low score of Self-Esteem and optimism. Recommendations: The study recommended that health promotion education program for renal failure and leukemia survivors, family members should be included in treatment regimen and health education for chronic illness patients, and develop continued training and education program for nurses, frequently attending and conferences based on their needs of chronic illness patients to improve Self-Esteem and optimism.