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Emphysematous pyelonephritis (EPN) is a rare, severe, rapidly progressive, necrotizing infection of the kidney parenchyma and its surrounding tissues. It represents a diagnostic challenge by virtue of its rarity and its clinical presentation similar to acute pyelonephritis (APN). Its surgical treatment is still controversial and the nephron-sparing approach is increasingly favored.Our study's aim was to assess clinical, biological, radiological and prognostic patterns of this pathology and appraise the place of its conservative management. Through a descriptive retrospective study, we reviewed the records of patients who were diagnosed with EPN and admitted to the Urology Ward of Monastir's teaching hospital, between the years 2015 and 2022. Lesions on CT-scans were classified according to Huang and Tseng classification and Wan et al. Classification and prognostic scores (NEWS, SOFA, NLR) were calculated.