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It is primarily used to diagnose vesicoureteral reflux (VUR) and posterior urethral valves (PUV), especially in cases of febrile urinary tract infections (UTIs), significant ureteral dilation on ultrasound, and\u2014in continent children\u2014urinary symptoms suggestive of infravesical obstruction. VCUG exposes children to a non-negligible dose of radiation and requires urethral catheterization, which can be painful\u2014particularly in males\u2014and carries a low but present risk of post-procedural UTI. Despite its widespread use, VCUG can miss VUR in up to 50% of cases. Moreover, recent studies report that preoperative suspicion of PUV on VCUG was present in only 46% of non-toilet-trained and 59% of toilet-trained males, likely due to challenges in interpreting the VCUG findings. In this review, we will highlight the clinical value, challenges, and areas of debate surrounding this diagnostic test, and offer practical tips to optimize its performance.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Graphical abstract<\/jats:bold>\n                  <\/jats:p>","DOI":"10.1007\/s00467-025-06901-3","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T14:30:58Z","timestamp":1757428258000},"page":"1287-1301","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Voiding cystourethrography for the pediatric nephrologist: clinical value, challenges, and areas of debate"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4682-0170","authenticated-orcid":false,"given":"Pierluigi","family":"Marzuillo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"La Manna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Luigi","family":"Palma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Tirelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Di Sessa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Russo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Reginelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnese","family":"Roberti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Verde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Guarino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Di Iorio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"6901_CR1","doi-asserted-by":"publisher","unstructured":"Frimberger D, Mercado-Deane M-G, Section on Urology, Section on Radiology (2016) Establishing a standard protocol for the voiding cystourethrography. 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