Percutaneous transluminal renal angioplasty (PTRA) has been infrequently used in the treatment of children with hypertension due to renal artery stenosis. We report our results in five patients aged 4 to 22 years with hypertension diagnosed at ages 1/2 to 10 years. Four of the five patients had been on antihypertensive medication prior to angioplasty. Four had fibromuscular disease and one had probable Takajasu's arteritis; two had solitary kidneys. Following angioplasty, a prompt decrease in blood pressure was observed in all patients. Further, four of five patients after PTRA were normotensive without antihypertensive medications, and in all PRA declined. PTRA can be a safe and effective alternative to surgical treatment in the management of renovascular hypertension in childhood. We suggest that PTRA should be the first procedure attempted to correct renovascular hypertension in children.