Membranous nephropathy, focal segmental glomerulosclerosis (FSGS) and IgA nephropathy are the most frequent and important primary glomerulopathies. Idiopathic membranous nephropathy and primary FSGS usually present with a nephrotic syndrome with or without renal insufficiency, whereas IgA nephropathy is more often characterized by (symptomless) hematuria and proteinuria. Although the outcome of these glomerulopathies is quite variable, many patients will progress to end-stage renal disease. In this review we discuss several aspects of the primary glomerulopathies with emphasis on the potential benefit of specific immunosuppressive regimens.