We performed an audit from 1995 to 2020 of patients with Wilms tumor in a referral center in Uruguay. Treatment included North American (NA) strategies (n=23) up to 2004 followed by SIOP strategy (n=35) thereafter (stage I-II=28, III=7, IV=14 and V=9). Delay in local radiotherapy was noted (median of 21 days after surgery). There was no toxic or surgical death or abandonment. Five-year pOS was 0.72 and 0.92 for the NA and SIOP respectively. Results favored the SIOP strategy with no unexpected toxicities and high treatment compliance in both strategies. Timely implementation of radiotherapy was challenging.