A six-year-old girl has persistent bilateral Grade 3 vesicoureteral reflux, first discovered after she presented with an E. coli urinary tract infection and fever at one year of age. What would you recommend? In the latest Clinical Decisions, three viewpoints are presented: continue prophylaxis, careful follow-up without antibiotics, or repair of the vesicoureteral reflux. At NEJM.org you can vote for one and then, if you wish, submit a comment about your decision. A recent Medical Progress review is also available on this topic, as well as teaching tools, like “Clinical Pearls” and “Morning Report Questions,” under Physicians-in-Training on our Now@NEJM blog.