Systemic lupus erythematosus (SLE) is a serious medical illness with frequent renal involvement at disease onset. Although predominantly affecting young women, SLE often first presents during childhood. Previous studies have suggested that patients with disease onset in childhood have a worse prognosis. Renal involvement in SLE is the major determinant of long-term outcome; the ten-year survival in children with lupus nephritis was only around 20% in late 60s, but outcomes have improved dramatically in recent years to around 94%. This article will review recent data on new approaches in the treatment of pediatric lupus nephritis by referencing the major studies over the last few years. We will also examine the validity of various factors that have been suggested by previous studies to have prognostic value in determining outcomes.