Hematuria is a common symptom of pediatric urological diseases, and its etiology is complex. If we cannot get timely and correct diagnosis, we often make inappropriate treatment plans, and some even delay the disease until the kidney damage is serious and affects the prognosis. Therefore, we should conduct selective and planned examinations for children with hematuria to clarify the cause as early as possible and to develop reasonable follow-up and treatment measures. Hematuria refers to the presence of more than normal amount of red blood cells in the urine, which is usually examined microscopically by taking 10 ml of clean fresh middle urine, centrifuging it on a centrifuge for 5 minutes, pouring off the supernatant, and examining the sediment microscopically; more than 3 urinary red blood cells per high-powered field of view can be designated as hematuria. When children are found to have deepened urine color or red, soy sauce-colored urine, first we must exclude several types of pseudohematuria: 1, the presence of certain metabolites and drugs in the urine such as urate, aminopyrine, rifampin, etc. to make the urine red, or the pigment in certain foods and vegetables to make the urine red, at this time, urine examination shows that the occult blood test and microscopic examination of red blood cells are negative can be excluded; 2, hemoglobinuria and myoglobinuria such as paroxysmal 2. Hemoglobinuria and myoglobinuria, such as paroxysmal hemoglobinuria, hemolytic anemia, etc., can make urine occult blood test positive, but microscopic examination does not have red blood cells; 3. Non-urinary tract bleeding, such as vaginal or lower gastrointestinal bleeding mixed with urine, menstrual contamination of urine, when urine occult blood test and microscopic examination of red blood cells are positive, so we need to carefully ask the medical history to exclude it. At present, according to the morphological changes of red blood cells in urine, hematuria is divided into two categories: glomerular hematuria refers to hematuria originating from the glomerulus, in which red blood cells appear in urine with different sizes and various morphological changes, i.e., mainly deformed red blood cells; non-glomerular hematuria refers to hematuria originating from the urinary system below the glomerulus. The blood vessels in the urinary tract rupture and bleed, and the morphology of red blood cells in the urine is basically normal and homogeneous. In addition, routine urinalysis can also help to identify hematuria with significant proteinuria and tubular pattern (especially red blood cell tubular pattern) as renal parenchymal lesions. The etiology of pediatric hematuria is more complex. The common causes of glomerular hematuria are: primary, secondary and hereditary glomerular diseases, such as acute nephritis, IgA nephropathy, nephrotic syndrome, lupus nephritis, purpura nephritis and hereditary nephritis. Non-glomerular hematuria is commonly seen in: urinary tract infection, stones, tuberculosis, hypercalciuria, left renal vein compression or nutcracker phenomenon, congenital urinary tract malformation, drug-induced kidney and bladder injury, tumor, trauma, etc. In addition, it is also seen in bleeding disorders, such as thrombocytopenic purpura, hemophilia, etc. It needs to be analyzed together with age, medical history, accompanying symptoms and signs, laboratory tests, and if necessary, kidney biopsy to confirm the diagnosis. In conclusion, hematuria is a complex problem with multiple etiologies. When the diagnosis is not clear after the above comprehensive analysis, long-term follow-up and dynamic observation are needed until the diagnosis is clear.