Infection of the urinary tract is common and results in significant morbidi
ty in infants and children. Within the last few decades, better understandi
ng of the pathogenesis and the natural history of pediatric urinary tract i
nfections (UTI), along with the identification of risk factors that predisp
ose to subsequent renal parenchymal damage, have led to the recognition tha
t prompt, appropriate, and thorough evaluation is essential for minimizing
the acute morbidity and the long-term sequelae such as renal scarring, hype
rtension, and renal failure. The goal of this article is to describe a rati
onal and practical approach toward evaluation and management of pediatric U
TI for the practicing pediatrician with additional emphasis on the appropri
ate use of acute and prophylactic antimicrobial agents.