The authors have examined immunogenetically 136 children of east slavonic nationality aged 5-15 years with different forms of congenital obstructive uropathy. Positive and negative association was found of some HLA antigenes, their phenotypical combinations and haplotypical combinations with diseases in the group of patients with congenital obstructive uropathies and in patients with obstructive pyelonephritis. Different immunogenetic picture was seen in patients with congenital hydronephrosis and in children with pyeloectosy. Different distribution of immunogenetic markers can be used for differential diagnosis, definition of the risk of progression of hydronephrotic transformation, complication of obstructive pathology with secondary infectious process and objective validation of therapeutic policy in children with congenital obstructive uropathy.