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Recurrent gross hematuria in children requires a well thought-out evaluation to address a long list of glomerular and extraglomerular etiologies, among which the nutcracker syndrome is usually included. Some authors have reported that this condition may be easily missed and underreported when hematuria is evaluated by routine diagnostic criteria. The child reported in this report was diagnosed with the nutcracker syndrome by specific imaging techniques only after an extensive investigation to address his hematuria, including a kidney biopsy and a cystoscopy, was negative. Here, Jodorkovsky and Milman raise the question of whether diagnosing the nutcracker syndrome early on in the evaluation of recurrent gross hematuria may spare some children prolonged, expensive, and invasive diagnostic procedures.