Hemolytic uremic syndrome is primarily a disease of childhood. Seventy three children presented with clinical signs and symptoms were studied in detail. Seventy four percent of them were under two years of age. Many of these children had clinical evidence of involvement of organs other than the kidney. Mortality among the children studied was 60%. The high mortality is possibly due to involvement of non renal organs in addition to factors like malnutrition, delay in seeking hospitalization etc. Some of the recent trends in the pathogenesis, pathology and management have been reviewed.