A family is described in which gross vesicoureteral reflux and renal scarring are present in the father and three sons, none with a history of urinary tract infection. Vesicoureteral reflux alone is present in an infant daughter. Father-to-son transmission of vesicoureteral reflux has not been previously reported. Autosomal dominant inheritance of the trait is suggested. The renal scarring noted in these patients may reflect generalized maldevelopment of affected renal units. The increasing recognition of vesicoureteral reflux as a familial trait suggests the need for evaluation of families in which vesicoureteral reflux is found in more than one member.