Urinary tract infections (UTI), both cystitis and pyelonephritis, are common in school aged children, though much less so than in younger children. Among those with urinary symptoms, such as painful urination or increased urinary frequency, 8% of children will have a UTI (Shaikh et al., Pediatr Infect Dis J 27:302–8, 2008). Diagnosis is important to prevent spread of infection to the upper urinary tract system, which can lead to renal scarring and significant morbidity. In this chapter, we will review risk factors, presenting symptoms, treatment and special considerations when caring for a child or adolescent with a UTI.