Emphysematous (Gas-forming) pyelonephritis (EPN) is a rare and life-threatening infection of the renal parenchyma with or without involvement of the peri-renal tissues. Diagnosis of this condition is usually made on clinical and radiological grounds. Risk factors for this condition include diabetes mellitus, urinary tract obstruction, renal anomalies such as polycystic kidneys, stones, old age and others. Review of the literature did not reveal any reports of (EPN) in the pediatric age group especially in transplanted patients. We report the first case of EPN in a child, a 12-yr-old boy with a renal transplant, and discuss the various diagnostic and management issues of this particular case and EPN in general.