We report five young patients who underwent percutaneous transluminal renal angioplasty (PTRA) for the treatment of hypertension related to renal artery stenosis. Four had fibromuscular disease and one had probable Takajasu's arteritis; two had solitary kidneys. Following PTRA, a prompt decrease in blood pressure was observed in all patients. Further, four of five patients long after PTRA remained normotensive, and in all patients plasma renin levels declined. These results indicate that PTRA can be a safe and effective alternative to surgery in the treatment of renovascular hypertension in childhood. © 1986 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.