Urinary tract infection is a frequent event in children. The correct diagnosis, management and study has been involved in major controversies in the last decade as a result of better design of scientific studies and evidence-based medicine in this area. A significant amount of our knowledge must be subjected to critical analysis because of new information available. This article describe some of the controversies in pediatric urinary tract infection that should be considered by the health team, highlighting the relevance of sample collection and the significant number of bacterial colonies, the type and duration of antibiotic treatment, the prescription of antibiotic prophylaxis and the required imaging study.