To study apolipoprotein E gene polymorphism in children with steroid- resistant idiopathic nephrotic syndrome (SRINS).Sixty children with SRINS (including 9 children with focalsclerosing glomerulonephritis) were observed in comparison with 80 age-sex-matched healthy children. Seven lipoprote in metabolism parameters including serum total-cholesterol(TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein AI(apoAI), apolipoprotein B (apoB), lipoprotein (a)[Lp (a)] were detected by enzyme method, and single-strand conformation polymorphism(PCR-SSCP) was used to determine the apoE genotypes in the two groups.Serum TC, TG, HDL-C, LDL-C, apoAI, apoB, Lp(a) in the observation group were significantly higher than those in the healthy controls (P<0.01). After 6 months, the levels of serum TC, TG, LDL-C,apoB,Lp(a) were 81.25%, 78.13%, 84.38%, 87.50% and 78.13% respectively in 32 SRINS cases of the observation group. The apo epsilon 2 allele gene frequence was higher in the observation group than in the controls (11.66% vs 5.00%, P<0.05). The apo apsilon 2 allele gene frequence in the cases of focalsclerosing glomerulonephritis was significantly higher than that in the controls (22.22% vs 5.00%, P<0.01).The above results indicate the obvious and long term abnormalities of serum lipoprotein metabolism in the children with SRINS. The apo apsilon 2 allele gene frequence is higher in the children with SRINS. There are risk factors for atherosclerosis and cardiovascular diseases in the children with SRINS. The antilipemic drugs should be considered in use for the children with SRINS.