One hundred and forty-three children with vesicoureteric reflux were treated conservatively at first. This retrospective study showed that the results of conservative treatment of severe reflux (Grade III) were poor and compare with other series. It is established that reflux of infected urine can cause scarring and there is increasing evidence that severe reflux of sterile urine can produce renal damage and stunt physical growth; once reflux ceases, or is corrected, renal function and growth as well as physical growth recover. We strongly urge that severe reflux (Grade III) should be treated aggressively and by antireflux surgery at an early stage. We concur that mild reflux (Grades I and II) can be successfully managed conservatively.