Representative case reports of children subjected to ureteroplasty in the management of reflux have been presented. Five- to 12-year follow-up studies were analyzed with reference to renal growth and pyelonephritic changes; the effect of the degree of preoperative reflux was recorded. The following conclusions appear warranted: 1. Severity of reflux is a major factor determining renal status; the more marked the reflux, the greater the frequency and extent of CPN. 2. Kidneys which appear normal initially usually remain so;however, CPN may develop, sometimes to a severe degree (Fig. 9). 3. The growth potential of pyelonephritic kidneys is quite variable and not readily predictable (Fig. 9). 4. Prolonged exposure to reflux appears to be an unfavourable situation possibly accelerating renal deterioration.