Vesicoureteral reflux (VUR) is commonly diagnosed in infancy during investigation of infants with urinary tract infection (UTI) or following demonstration of prenatal urinary tract dilatation. High grade reflux in infancy is mainly seen in males, in contrast to older children when it is less severe and affects females more commonly. Associated renal parenchymal damage in infants can be congenital renal dysplasia or acquired segmental scarring that results after a combination of UTI and intrarenal reflux. Whether it is congenital damage or infection related damage, these infants need early identification and protection from further damage to ongoing high grade VUR and/or UTIs. Endoscopic correction is a safe, effective, minimally invasive procedure for high grade VUR in infants. Early correction of VUR may provide protection from reflux associated renal damage and prolonged antibiotic use.