Thirty percent of children with urinary tract anomalies have urinary tract infection (UTI) as their initial presentation. If we fail to identify patients at risk, they are at risk for upper urinary tract damage. Up to 85% of febrile UTI infants and children have visible photon defects on technetium Tc-99-labeled dimercaptosuccinic acid (DMSA) scans. Between 10-40% of these children have permanent renal scarring that may lead to renal dysplasia, recurrent pyelonephritis, impaired glomerular filtration rate, early hypertension, end-stage renal disease, and pre-eclampsia. Identifying which children are at risk for renal cortical damage and the need for follow-up imaging after UTI are controversial. Based on the available evidence and expert consensus, the European Association of Urology (EAU)/European Society of Pediatric Urology (ESPU) Pediatric Guidelines Committee has provided recommendations and updated guidelines for the diagnosis, treatment, and imaging of UTI in children. UTI is the most common bacterial infection in children. Up to 30% of infants and children experience recurrent infections in the first 6-12 months after initial UTI. In very young infants, UTI symptoms differ in many ways from those of older infants and children. The incidence is higher in the first age group, with a definite male predominance. Most infections are caused by E. coli. However, infections with S. pneumoniae, Enterobacter spp., Enterococcus spp. and Pseudomonas spp. are more common in infants within one year of age compared to after one year of age, and the risk of UTIs is higher compared to adults. The incidence of UTIs varies by age and sex. Within one year of age, UTIs are more common in boys (3.7%) than in girls (2%). A prospective study included more than 1,000 patients and urine specimens were obtained by catheterization. The study found that UTI was more common in febrile infants up to 2 months of age, with an incidence of 5% in girls and 20.3% in uncircumcised boys. the incidence varied after 2 months of age, with 3% of prepubertal girls and 1% of boys diagnosed with UTI.