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Urinary tract infections (UTIs) are one of the most diagnosed bacterial infections in febrile pediatric patients, identified through urinalysis and urine culture, and typically treated with antibiotics. Young healthy patients in this population present a unique group who cannot endorse urinary symptoms, creating a clinical dilemma that usually results in default testing for UTIs. Additionally, there remains significant ambiguity in diagnostic criteria pertaining to the urinalysis and urine culture, further complicated by variations in the route of specimen collection and clinical presentation. These factors present technical difficulties in optimal diagnostic criteria unique to the healthy pediatric population, leading to ample opportunities for overdiagnosis.Overdiagnosis describes instances in which a correct diagnosis is made, based on current clinical standards, but the deliverance of the diagnosis and associated treatment does not benefit and may instead harm the patient. In the case of pediatric UTIs, those consequences include trauma from catheterization or suprapubic aspiration, antibiotic overuse causing microbial resistance or medication side effects, and increased financial and psychological burden. Furthermore, testing and imaging such as renal ultrasounds and voiding cystourethrogram may be obtained, though with little value for their findings. So, the dilemma boils down to this: is treating and diagnosing all UTIs necessary?There is current and past literature in support of the hypothesis that we diagnose and treat too many UTIs. which in the pediatric population may be self-limited in many instances. This includes a recent study in JAMA Peds providing compounding evidence for overdiagnosis. Liang et al looked at UTI incidence during the COVID pandemic and found decreased diagnosis during early COVID without increased clinical complications, most likely from a reduction in overdiagnosis. These studies support the claim that there is room for more conservative clinical pursuance of UTIs, without acute consequences such as septic shock, dehydration, or need for hospitalizations.Pediatric fever guidelines in the past have often placed UTIs at the same level as meningitis and bacteremia in the pursuit of a cause for fever in the overarching term of ‘serious bacterial infections’. While we cannot deny that in the subset of the pediatric population with high-risk factors, UTIs can and should be pursued, older and newer literature suggests that there may be large groups of healthy children in which the clinical decision to pursue a UTI diagnosis is unwarranted.Our session proposes that the aggressive pursuit of UTIs in the pediatric population has significant implications and consequences. We plan to walk the audience through past evidence regarding outcomes of UTI treatment in children and present the current evidence, which suggests overdiagnosis. The aim of this session is to start a conversation surrounding the opportunity for decreasing the aggressive pursuit of pediatric UTIs. New guidelines should consider and incorporate the idea of overdiagnosis, especially considering positive urinalysis and urine culture standards. By viewing UTIs through new lenses, there is a chance to increase value by diagnosing and treating fewer UTIs, with confidence that there is no clear harm in clinical outcomes.