Most pediatric renal trauma is minor and poses no significant danger to the child. A small percentage of children sustain a severe renal injury that demands immediate evaluation and decision of operative versus nonoperative management. Selective management of pediatric renal trauma based on mechanism of injury, hemodynamic stability,associated nonrenal injuries, and CT imaging has led to a renal exploration rate of 5%to 11% with renal salvage rates of more than 98%.