Background: Nephrotic syndrome is a common pediatric kidney condition t. It happens in young children and adolescents. The goal of this research was to investigate the diagnostic value of urinary MCP-1 in pediatric patient with idiopathic nephrotic syndrome. Methods: At the pediatric nephrology outpatient clinic and the pediatric nephrology unit, this case-control study was carried out at Zagazig university hospitals on children attending at pediatric inpatient and outpatient clinic. They were divided into three groups: group A, which consisted of 27 nephrotic patients in remission; group B, which consisted of 27 nephrotic patients who were active and experiencing either their first attack or relapses; and group C, which consisted of 27 sex- and age-matched healthy children who were present at a general pediatric clinic. Results: There is a statistically significant difference in urinary monocyte chemotactic Protein 1. The best cutoff of urinary monocyte chemotactic protein 1 in diagnosis of nephrotic syndrome is ≥79 with area under curve 1, sensitivity 100%, specificity 96.3%, positive predictive value 98.2%, negative predictive value 100%, and overall accuracy 98.8%. The best cutoff steroid-resistant nephrotic syndrome by using urine monocyte chemotactic protein 1 as a diagnostic marker is ≥512 with area under curve 0.992, sensitivity 96.3%, specificity 88.9%, positive predictive value 89.7%, negative predictive value 96%, and overall accuracy 92.6%. Conclusion: The findings imply that urine MCP-1 levels can differentiate between patients with active disease and those who are in remission, as well as between cases of steroid-resistant nephrotic syndrome and cases of steroid-sensitive nephrotic syndrome.