A renal ultrasonographic study was performed on 20 infants with congenital nephrotic syndrome of the Finnish type. Follow-up ultrasonographic data were obtained on 13 of these patients. The renal lengths increased after 2 months of age. Later, at the age of approximately 18 months, the renal size had decreased again, and was within 2 SD of the predicted mean value. During the first 2 months of life the renal cortex was hyperechogenic and corticomedullary differentiation was clearly visible. Between 2 and 12 months of age the renal cortex was still hyperechogenic in all kidneys, but corticomedullary differentiation had disappeared from 10 of the 26 kidneys examined. After 12 months of age the kidney parenchyma was hyperechogenic and most kidneys had lost corticomedullary differentiation. Thus, the sonographic follow-up is one of the main diagnostic indices f congenital nephrotic syndrome.