Renal histopathology of verotoxin producing escherichia coli(VTEC) related hemolytic uremic syndrome (HUS) was described. Endothelial damage is expressed in renal small arteries and glomeruli as luminal narrowing due to endothelial swelling and subendothelial edema. Extracellular matrix shows reticularization and/or mesangiolysis in glomeruli. Although HUS and thrombotic thromocytopenic purpura (TTP) is recently considered as a single entity, the tissue expression is different. In the latter endothelial proliferation is profound resulting in arteriolar deteriolation such as glomeruloid structure.