In this section, we delve into the endoscopic treatment for vesicoureteral reflux (VUR), a common urological condition in children. Our focus is on evaluating the safety and efficacy of various bulking agents used in subureteric injection procedures. VUR is notably linked to a higher occurrence of urinary tract infections in children, particularly those with prenatal hydronephrosis or a family history of the condition. We trace the evolution of bulking agents from the initial use of Polytetrafluoroethylene (PTFE) to more recent advancements in biodegradable materials like Polyacrylamide hydrogel (PAHG) and Deflux® (dextranomer/hyaluronic acid copolymer), which have shown promising results in terms of safety and effectiveness. We further highlight the benefits of Deflux, which has been approved by the FDA for pediatric use, noting its absence of immunogenic reactions and its stability within the injection site, alongside discussing its varied success rates across different VUR grades. Attention is also given to Vantris® (Polyacrylate polyalcohol copolymer), emphasizing its remarkable 100% success rate after two procedures in certain studies, while also cautioning about the potential risk of ureterovesical junction obstruction. Moreover, we outline the surgical techniques utilized, underlining the critical importance of precision to ensure optimal outcomes, and discuss follow-up protocols designed to monitor treatment success and address persistent VUR. The role of endoscopic treatment within the overall management of VUR is thoroughly examined. Although endoscopic treatment represents a less invasive option with generally lower complication rates, we acknowledge the need for comprehensive studies to fully ascertain its efficacy compared to conservative treatment and open surgery.