Vesicoureteral reflux (VUR), one of the most common urological anomalies in children, can lead to recurrent pyelonephritis, with the possible results of renal scarring, hypertension and end-stage renal disease. Diagnostic procedures required when VUR is suspected prenatally on the grounds of an ultrasound image or after a urinary tract infection (UTI) are ultrasound, voiding cystourethrogram, and within the first year of life dynamic renal scintigraphy to exclude concomitant obstruction; after the first year a DMSA renal scintigram should be performed to exclude renal scarring after UTI. Therapy depends on the age of the patient and the severity of the VUR. In the first year long-term antibiotic prophylaxis is generally indicated for any grade of VUR. Surgical correction (conventional or endoscopic surgery) is indicated when VUR progresses or persists beyond the first year of life, when patient compliance with antibiotic prophylaxis is poor and when a fresh UTI occurs even during the antibiotic prophylaxis. The long-term course depends on the damage to the kidney(s).