Urinary tract infection (UTI) is a common bacterial infection in the pediatric population, with a host of factors contributing to initial and ongoing infection risk. Both positive urinalysis (pyuria and/or bacteruria) and clean catch or catheterized culture demonstrating uropathogen(s) are required to accurately establish a UTI diagnosis. Empiric antibiotic choice should be based on prior cultures, if available, and the hospital antibiogram. Children with febrile or recurrent infections warrant renal–bladder ultrasound and possible voiding cystourethrogram to rule out urinary tract anomalies and guide additional management. Management options for pediatric vesicoureteral reflux include antibiotic prophylaxis as well as endoscopic, laparoscopic/robotic, and open surgical correction. Bladder and bowel dysfunction should be screened for and promptly addressed in children with UTI.