Proteinuria in children is most often transient or orthostatic. However, the diagnosis and treatment of persistent proteinuria may significantly impact long-term health outcomes, as persistent proteinuria is both a sign of underlying kidney pathology as well as a modifiable risk factor for progression of kidney disease. The differential diagnosis of proteinuria differs depending on whether proteinuria is glomerular or tubular. This article reviews the pathophysiology, evaluation, and management of proteinuria, including an emphasis on the management of idiopathic nephrotic syndrome.