Hematuria is a common symptom of pediatric urological diseases, and its etiology is complex. If we cannot get timely and correct diagnosis, we will often make inappropriate treatment plan, and some of them even delay the condition to severe kidney damage and affect the prognosis. Therefore, we should carry out selective and planned examination for children with hematuria to clarify the etiology as early as possible and formulate reasonable follow-up and treatment measures. Hematuria refers to the presence of more than the normal amount of red blood cells in the urine, usually microscopic examination as a standard, the method is to take 10 ml of clean fresh mid-range urine, centrifuged in a centrifuge for 5 minutes, the supernatant will be poured off, the sediment with a microscope to check, more than 3 urine red blood cells per high magnification field of view can be defined as hematuria. When the discovery of children with urine color deepening or red, soy sauce color urine, first of all, we have to except several false hematuria: 1, the presence of certain metabolites in the urine and drugs such as urate, aminopyrine, rifampicin and so on to make the urine red, or certain foods, vegetables in the pigment to make the urine red, at this time, the urine examination shows that the occult blood test and the microscopic examination of the red blood cells can be excluded from negative; 2, hemoglobinuria and myoglobinuria, such as paroxysmal Sleeping hemoglobinuria, hemolytic anemia, etc., can make the urine occult blood test is positive, but the microscopic examination does not have red blood cells; 3, non-urinary bleeding such as vaginal or lower gastrointestinal bleeding mixed into the urine, menstrual contamination of the urine, this time, the urine occult blood test and microscopic examination of red blood cells are positive, so you need to ask a careful history to rule out. Determine is true hematuria, further to determine the source of hematuria, according to the changes in the morphology of the red blood cells in the urine, hematuria is divided into two categories of glomerular and non-glomerular hematuria: glomerular hematuria refers to hematuria originating from the glomerulus, the red blood cells in the urine appeared in varying sizes, a variety of morphology, that is, the main deformation of the red blood cells; non-glomerular hematuria refers to hematuria originating from the glomerulus of the urinary tract below the glomerulus, the blood vessels rupture bleeding, the urine in the urinary tract. Urinary blood vessel rupture bleeding, urine red blood cell morphology is basically normal and uniform. In addition, routine urinalysis can also help to identify, such as hematuria with obvious proteinuria, tubular (especially erythrocyte tubular) for 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, hereditary nephritis and so on. Non-glomerular hematuria is commonly seen in: urinary tract infections, stones, tuberculosis, hypercalciuria, left renal vein compression or nutcracker phenomenon, congenital urinary tract anomalies, drug-induced renal and bladder injuries, neoplasms, trauma, etc. In addition, it is also seen in hemorrhagic disorders, such as thrombotic thrombocytopenic purpura and hemophilia. It needs to be analyzed with age, medical history, accompanying symptoms and signs, laboratory tests, and renal biopsy if necessary to confirm the diagnosis. In conclusion, hematuria is a complex problem with multiple etiologies. If the diagnosis is still not clear after the above comprehensive analysis, long-term follow-up and dynamic observation are needed until the diagnosis is clear.