Abstract: Objective: To study the effect of methylprednisolone pulse therapy on Henoch-Sch?nlein purpura nephritis (HSPN) with nephritic syndrome in chlidren. Methods: Twenty-four children of HSPN with nephritic syndrome were enrolled in this study. Children were divided into 2 groups: steroid pulse therapy group (SP group, n=13 ), and steroid oral therapy group (SO group, n=11). Cyclophosphamide pulse therapy and regular dipyridamole were given in both groups. Methylprednisolone (15～30 mg/kg, given every other day for 6 times) was given to children in SP group. Prednisone 1.5～2.0 mg/（kg·d）was given for other 4 weeks and then tapered. If proteinuria was non-remission at the 3rd and 5th month, methylprednisolone pulse therapy was repeated. Methylprednisolone was not given to children in SO group. Routine urine test was performed before steroids therapy and one month to five months after the starting of steroids therapy. The qualitation of the urinary protein and red blood cells were performed. Results: One month after the starting of steroid therapy, the total effective rate of proteinuria decreasing was 92% in SP group, significantly higher than that of 45% in SO group (P<0.05)，two and three months after the starting of steroids therapy, excellence rates of proteinuria decreasing were 67% and 91% in SP group, 18% and 3/9 in SO group respectively. The differences between the two groups were significant（both P<0.05）. For hematuria decreasing, marked effectiveness were seen in 1 case and 2 cases, and total effective rates were 31% and 75% respectively in the first month and the second month in SP group, whereas marked effectiveness was not seen in SO group, with a total effective rate of 36% and 36% in the first month and the second month respectively. Conclusion: Mythelprednisolone pulse therapy reduces proteinuria and hematuria faster than prednisone oral therapy for HSPN with nephritic syndrome in children.