Background: Nephrtoic syndrome (NS) comes at the top of most prevalent kidney morbidities in Africa constituting 40% of renal disorders in Egypt. Minimal changes NS representing 88% of patients with NS. Glomerular risk factors of NS can be classified into either primary or secondary. Aim of the Work: to estimate serum levels of IgG, IgM, in NS cases comparing them with healthy children in addition to detect the relationship between IgG/IgM ratio and response to treatment with steroids. Patients and Methods: This was an observational cohort prospective study was conducted on 60 subjects recruited from Pediatric Department, Sohag University Hospital during a period of one year from 2015 to 2016. All included patients underwent detailed history taking, medical examination, laboratory investigations, serum albumin, complete blood count with differential white blood cell count, serum immunoglobulin G, immunoglobulin M, were measured in patient groups; group A included 15 patients. They had NS, received steroids for 8 weeks and not respond. They were steroid-resistant Ns (SRNS). group B included 15 patients with SSNS with infrequent relapse, group C included 15 patients with SSNS with frequent relapse, group D included 15 healthy children as a control group. Results: a statistically significant difference was found between groups as regard IgG/IgM ratio. Conclusion: Serum IgM and IgG levels have prognostic value in patients with nephrotic syndrome and can predict the outcome and the frequency of recurrence of disease. There is a close relation between the degree of albuminuria and the levels of serum IgG and M.