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Of the 59 renal arteries studied by DSA, 22 were abnormal on CT angiography and 20 were abnormal on DSA. Of the 59 renal arteries, CT angiography was true positive in 18 and true negative in 35. The sensitivity and specificity of CT angiography for RAS diagnosis were 90.0% and 89.7%, respectively. CT angiography identified all cases of main RAS. Renal CT angiography has a high sensitivity and specificity for pediatric RAS diagnosis in patients referred for DSA. Renal CT angiography has a high sensitivity and specificity for pediatric R