Radiologic imaging plays a crucial role in diagnosing and managing pediatric urinary tract infections (UTIs). The challenge lies in balancing the need for accurate diagnosis and follow-up care with concerns about unnecessary imaging, radiation exposure, and healthcare costs. A sustainable approach to follow-up care involves minimizing unnecessary imaging while still ensuring that high-risk patients receive appropriate diagnostic evaluations. This article explores the current role of radiology in pediatric UTIs, emphasizing sustainable approaches to follow-up care, updated guidelines, and recent advancements in imaging techniques.