The care of patients with traumatic rupture of the kidney has been and continues to be a controversial subject in urology. Difference of opinion exists both with regard to the method and extent of the radiological investigation necessary for an understanding of the case and as to the form of treatment to be used—conservative non-operative measures or surgery. With these questions in mind, particularly that of the extent of the radiological investigation, we have reviewed 17 cases of traumatic rupture of the kidney seen in the Toronto General Hospital in the six years from June 1947 to June 1953. X-ray examination included anteroposterior views of the abdomen, intravenous pyelography, and retrograde pyelography. A plain film of the abdomen may show loss of the kidney shadow or its enlargement, obliteration of the psoas muscle, scoliosis with concavity to the affected side, fractures, etc. The examination is harmless so far as the patient's general condition is concerned, but unfortunately it does not often give much information, because of overlying gas-filled bowel, the results of a paralytic ileus. In 15 of the 17 patients under review anteroposterior films of the abdomen were obtained. In 2 of the cases a large mass was seen on one side, while in 2 others there was evidence of trauma in the region of the kidney, such as fractures of the ribs or of transverse processes of the vertebrae. Excretory pyelograms are without danger so far as infection is concerned. They are easily obtained and offer valuable information in the majority of cases. They are best done on admission, though at that time failure of function on the injured side may be apparent. A few days later, however, a repeat examination may be satisfactory. The injured kidney may show extravasation of the medium into the parenchyma of varying degree according to the extent of the injury sustained. Deformity of the calyces, pelvis, or ureter may be seen, the result either of blood clot within or of pressure from without by an extrarenal mass. From the point of view of determining the treatment to be carried out, it is of great importance that the condition of the non-injured kidney be observed. Turton and Williamson (4) reported 5 cases in which a congenital solitary kidney sustained injury, and in 4 of these cases nephrectomy was performed. That cystoscopic examination and retrograde pyelography should be routine procedures is the opinion of certain writers, as Sargent (3), Farman (1), and Orkin (2). They contend that a much better pyelogram is obtained and that extravasation, when present, is much more apparent than on the intravenous study. Opponents of retrograde pyelography maintain that it carries with it the danger of introducing infection and of increasing or re-activating bleeding.