Continuous antibiotic prophylaxis (CAP) is frequently utilized in the management of vesicoureteral reflux with the goal of preventing urinary tract infections (UTI), and more importantly permanent renal damage, which can have long term negative effects including kidney disease and hypertension. Although the utilization of CAP has been found to decrease the risk of UTIs, the decreased risk of developing renal scarring in the long run has been controversial. Moreover, the price to pay for implementing CAP has been the association with a marked increase in developing bacterial resistance. Thus, the potential benefits of prescribing CAP must be weighed against long term complications of antibiotic usage, both on an individual and global level. Hopefully, ongoing and future studies will continue to emerge with the goal of better identifying patients who are most likely to benefit from CAP in order to maximize their utility while minimizing the risk of side effects and complications.