We reviewed our experience with percutaneous nephrostomy placement in children less than one year of age during a five-year period. Placement was successful in 8 of 9 cases. There were no complications. The procedure favorably altered the outcome for each patient and was useful for reversing azotemia prior to surgical intervention for repair of an obstructed system (2 renal units), for providing drainage of pyonephrotic kidneys (3 renal units), for demonstrating inadequate recovery of renal function after relief of obstruction (2 renal units), and for replacing a surgically placed nephrostomy that was dislodged (1 renal unit). Our experience has encouraged us to accept the technique, and we believe that it is a valuable nonsurgical alternative that should be available to urologists managing infants with urinary tract pathology.