This chapter outlines key pediatric urologic emergencies. The information is organized following the genitourinary tract anatomy from the top down, including conditions that affect the adrenal glands, kidneys, bladder, and external genitalia. Adrenal emergencies, such as salt-wasting congenital adrenal hyperplasia (CAH), can result in ambiguous genitalia and life-threatening complications such as dehydration and shock. Rapid diagnosis and multidisciplinary management are critical. Renal conditions, including cystic and solid lesions, pyelonephritis, trauma, and calculi, require appropriate imaging evaluation and timely medical or surgical interventions based on severity. Bladder emergencies include exstrophy, trauma, and complications from augmentations, and they often necessitate immediate catheter-based or expedited surgical treatments. Urinary retention in neonates can signal more serious anomalies such as posterior urethral valves, anorectal malformations, or spinal cord issues. External genital emergencies, such as paraphimosis, phimosis, urethral or penile trauma, and testicular torsion, demand prompt management to prevent ischemic or infectious sequalae. Overall, pediatric urologic emergencies require swift recognition to make the proper diagnosis. Management often needs multidisciplinary approach and individualized care, considering unique anatomical and developmental factors of each patient. For some conditions, regular follow-ups are essential to address long-term potential complications and psychosocial impacts.