Background: Nephrotic syndrome is a prevalent glomerular condition that is characterized by edema, hypoalbuminemia, hyperlipidemia, and severe proteinuria. Proteinuria leading to loss of important plasma proteins likes fibrinogen, protein C, S and AT III. As a result, the vascular system is more susceptible to hypercoagulability and plasma anticoagulant factor levels are lower. This study aimed to evaluate the effect of nephrotic syndrome on coagulation status. Methods: This case-control study was conducted at the Pediatric Nephrology Unit at Zagazig University Hospitals over a period of six months. The study included 40 nephrotic children in different disease activity and 40 healthy controls matched for age and sex. All participants underwent complete history-taking, physical examination, and laboratory studies, including fibrinogen, protein C, protein S (By ELISA) AT III and platelet indices. Results: Plasm levels of protein S, protein C and AT III during activity (onset and relapse) were significantly lower than their levels at remission and in healthy controls. The mean level of fibrinogen was significantly higher during activity than its level during the remission period and in the control group. Correlations between changes in coagulation parameters and biochemical findings were also investigated. Serum albumin levels were positively correlated with plasma AT III, PC, and PS (P