Objective　To explore the relationship of pathological patterns of renal biopsy with immunofluorescence the therapeutic effects of corticosteroid in childhood nephrotic syndrome. Method　Renal biopsy materials and clinical data of the children diagnosed with nephrotic syndrome in the Department of Pediatric Nephrology of Shanghai Xinhua Hospital from January, 1990 to December, 2015 were retrospectively reviewed and analyzed. Results　The renal pathological patterns by immunofluorescence of 252 patients showed that IgA was presented in 13 cases (5.16%), IgM in 78 cases (30.95%), complement in 19 cases (7.54%), IgG+A+M in 17 cases(6.75%), IgG+A+M+complement in 22 cases (8.73%), IgA+complement in 2 cases (0.79%), IgM+complement in 55 cases (21.83%), and there was no immune complex present in 46 cases (18.25%). The renal pathological patterns were found that 157 (62.3%) minimal change nephropathy syndrome (MCNS), 35 (13.89%) mesangioproliferative glomerulonephritis (MsPGN), 60 (23.81%) focal and segmental glomerulosclerosis (FSGS). In the 4 weeks of oral administration of prednisone, complete remission was achieved in 167 cases (77.31%), partial remission was achieved in 31 cases (14.35%), and no remission was shown in 18 cases (8.33). There was statistically difference in the distribution of renal pathological patterns among the 8 patterns by immunofluorescence (χ2=31.308， P=0.001). The therapeutic effects of corticosteroid  on the 8 patterns by immunofluorescence have no significant difference (P>0.05). Conclusions　The distribution of renal pathological patterns among the 8 patterns of immunofluorescence is significantly different.