Diarrheal-associated hemolytic uremic syndrome (D+HUS) is the most common cause of acute renal failure in children. Approximately 5-10% of patients who have gastroenteritis due to Shiga toxin-producing strains of E.coli (STEC) will develop this complication. At present, the only proven therapy for this illness is aggressive management of the acute renal failure and serious extra-renal events. SYNSORB Pk, an oral agent that binds Shiga toxin within the intestinal lumen and prevents absorption into the systemic circulation, is the only agent that is currently undergoing testing in a randomized, placebo-controlled clinical trial. Alternative treatments that are under development include genetically modified bacteria that can bind Shiga toxin, newer agents with enhanced avidity and binding capacity for Shiga toxin, and monoclonal antibodies to Shiga toxin. Finally, immunization strategies against STEC infection are being evaluated. It is hoped that together with improvements in food processing technology, these new treatments will prevent morbidity and mortality from D+HUS.