Although xanthogranulomatous pyelonephritis (XGP) is a rare condition, mimicking majority of renal pathologies, recent reports suggest an increase in correct diagnosis. The clinical records of 11 children with diffuse XGP who had been treated surgically between 1987 and 1998 at our clinic were studied retrospectively, XGP was not suspected preoperatively in any of the patients. There were 6 boys and 5 girls, with an age range of 1 to 9 years. Lesions were left-sided in 8 and right-sided 3 patients. All of them had a nonfunctioning kidney and underwent nephrectomy. Preoperative diagnoses were, nephrolithiasis in 5, perinephritic abscess in 3, pyonephrosis in 2 and renal tumour in 1 of the patients. Follow-up period ranged from 8 months to 8 years, without any evidence of recurrence and maintenance of renal function in all cases. Since XGP is a histopathological diagnosis, in fact, the clinician who uses advanced diagnostic modalities may suspect its presence but can not make a correct preoperative diagnosis.