The chapter highlights the common causes of hematuria in children and suggests a systematic approach to evaluation of these children. Hematuria is a common presenting feature of diseases or abnormalities of genitourinary system and systemic diseases like coagulation disorders. It rarely could be factitious. It is not uncommon for children to present to the emergency room with hematuria. The prevalence of gross hematuria, based on a retrospective review of children seen in an emergency clinic was 0.13 percent. The goals for the physician attending to a child with hematuria in the emergency are: (i) to recognize and confirm the finding of hematuria, (ii) to identify common etiologies for hematuria, and (iii) to identify children with significant genitourinary disease who need further evaluation and management. Hematuria is defined as more than 5 red blood cells (RBCs) per high-power fields in the urinary sediment. Blood in the urine that is visible without microscopy is gross hematuria and finding RBCs in urine on microscopy is termed microscopic hematuria. Hematuria can result from non-renal, and glomerular and extraglomerular abnormalities.