This article covers some of the historical features of the recognition and treatment of vesicoureteral reflux as well as the relationship of its diagnosis to urinary tract infection. The causes of reflux, studies necessary to make a diagnosis as well as its significance as relates to the kidneys, are reviewed. A plan for the management of the child with vesicoureteral reflux is offered, and the outstanding question regarding how to deal with the preadolescent with persisting reflux is raised.