Abstract Background: The objective of the study is to develop a program of scoring for determining the degree of impairment of urodynamics and the preservation of renal function in children with obstructive uropathy on the basis of data from ultrasound - Doppler studies. Methods: The work is based on the results of ultrasound and Doppler examination of 484 children with congenital obstructive uropathy. In accordance with the obtained data, a point assessment of the degree of impairment of urodynamics and preservation of renal function was carried out in 60 children with obstructive uropathies (30 children with congenital hydronephrosis and 30 children with congenital ureterohydronephrosis). Results: Analysis of ultrasound and Doppler studies in congenital obstructive uropathy in children by comparing the data, depending on the severity and level of obstruction, revealed 3 degrees of congenital obstruction of the upper urinary tract in children. A comparative study of the urodynamics and state of the renal parenchyma, depending on the degree of obstruction, established a close relationship between the indicators of the functional state of the renal parenchyma and the degree of dilatation and disorders of the urodynamics of the upper urinary tract. Conclusion: The developed program allows the safe and most informative methods to reliably determine the functional state of the renal parenchyma and the degree of urodynamic impairment in children with obstructive uropathy. Study Registration (ClinicalTrials.gov) ID NCT04605835.