Introduction: Acute Kidney Injury (AKI) is a prevalent and critical condition that significantly impacts patient outcomes in tertiary care settings. This study aims to elucidate the etiological factors and laboratory profiles of patients diagnosed with AKI in a tertiary care center. Methods: A retrospective analysis was conducted on 150 patients admitted with AKI from January 2021 to December 2023. Data on demographic characteristics, underlying etiologies, clinical presentations, and laboratory parameters were collected and analyzed. Results: The predominant etiological factors identified included sepsis (35%), hypovolemia (25%), nephrotoxic drugs (15%), and obstructive uropathy (10%). Other causes such as glomerulonephritis and acute tubular necrosis accounted for the remaining 15%. The mean age of the patients was 60 years, with a male predominance (60%). Laboratory findings revealed significant elevations in serum creatinine and blood urea nitrogen levels, with mean values of 4.5 ± 1.8 mg/dL and 75 ± 25 mg/dL, respectively. Electrolyte imbalances, particularly hyperkalemia and metabolic acidosis, were prevalent among 45% of the patients. Urinalysis showed proteinuria in 50% and hematuria in 30% of the cases. Conclusion: The study highlights the critical need for early identification and management of AKI, emphasizing the importance of understanding its diverse etiologies and laboratory profiles. The findings underscore the role of sepsis and hypovolemia as leading causes of AKI, necessitating prompt therapeutic interventions. This comprehensive analysis provides valuable insights into the etiopathogenesis of AKI, which can inform clinical practice and improve patient outcomes in tertiary care settings. Future research should focus on preventive strategies and optimizing treatment protocols for AKI to reduce its morbidity and mortality.