Nephrotic syndrome is among the most common kidney diseases in children and it occurs as a result of damage to the glomerular filtration barrier. It is characterized by edema, nephrot­ic range proteinuria, hypoalbuminemia and hyperlipidemia. The most common form of child­hood nephrotic syndrome is idiopathic nephrotic syndrome. Most children respond to steroid therapy and although they have repeated relapses, they are unlikely to develop chronic kid­ney disease. However, ten percent of children fail to respond to steroid therapy and are at an increased risk of developing end-stage renal disease. The paper describes the case of a 3-year old girl who presented to hospital with periorbital and lower limb edema and the diagnosis of idiopathic nephrotic syndrome was confirmed. The stepwise approach to the treatment of childhood nephrotic syndrome is also described.