Clinical and pathological features of the nephrotic syndrome were studied in 36 adults and 25 children in Ghana. No evidence was found to implicate Plasmodium malariae as a cause and in the majority of patients the aetiology was not identified. Minimal change glomerulonephritis responsive to steroids was demonstrated in 14/25 children and 5/36 adults which was surprising as this lesion has been reported only rarely from tropical Africa. The other major histological lesions were focal segmental glomerulosclerosis (12/61), diffuse proliferative glomerulonephritis (11/61) and membranous glomerulonephritis (9/61).