Background: Nephrotic syndrome (NS) is a common childhood kidney disease caused by impaired glomerular function, characterized by protein leakage from the blood to the urine through the glomeruli, resulting in proteinuria, hypoalbuminemia, hypercholesterolemia and generalized edema. NS is descriptively classified upon the patients’ response to steroid treatment as steroid-sensitive NS (SSNS) or steroid-resistant NS (SRNS). Frequent relapses and dependency on steroid therapy are common clinical features. Aim: to describe patients' response to the different therapeutic modalities used for steroid dependent NS (SDNS) and SRNS. Methods: This retrospective study included 102 pediatric patients, 53 (51.96%) were SRNS and 49 (48.04%) were SDNS who were attending the Nephrology Outpatient Clinic, Children's Hospital, Cairo University for follow-up. Results: Out of 53 SRNS patients, 29 (54.72%) patients showed complete response to immunosuppressive therapy, while 14 (25.42%) patients showed partial response to therapy and the remaining 10 (18.87%) patients showed no response to treatment. Cyclophosphamide was the main immunosuppressive used as a first line of treatment in SRNS. Out of 49 SDNS patients, 26 patients became infrequent relapsers (53.06%), 20 patients (40.82%) became dependent on a lower prednisone dose (12 on a dose of <0.1 mg/kg/day and 8 on a dose of >0.1 mg/kg/day, 2 of latter became later SRNS) and 3 patients (6.12%) showed no improvement. Conclusion: cyclophosphamide is a good choice as a first line for treatment of SRNS. Levamizole or azathioprine are better used in low dose SDNS, and cyclophosphamide and cyclosporine in high dose SDNS.