Acute emphysematous pyelonephritis is a necrotizing and suppurative infection of the renal parenchyma and perirenal tissue with in situ production of gas of bacterial origin. This is a rare disease, occurring preferentially in diabetics and its mortality is hight. Our study aims to highlight the clinical and paraclinical characteristics as well as the particularity of therapeutic management of this pathology. We analyzed the medical files of patients treated for treated in the Department of Urology A; of the CHU IBN SINA Rabat between 2005 and 2020. For each medical file we specified clinical, paraclinical and therapeutic characteristics as well as the evolution after treatment. The treatment of those patients can typically be divided into medical management, medical management plus endoscopic or percutaneous drainage, and emergency nephrectomy. Nevertheless, given that there are very few guidelines or treatment algorithms, there is no consensus on the mana- gement of patients with emphysematous pyelonephritis.