Background &Method: The aim of the study is to compare the efficacy of oral furosemide- metolazone versus oral furosemide- spironolactone combination therapy in management of edema in nephrotic syndrome. All children of age group 6 months -14 years attending the out-patient department (OPD) and In-patient department (IPD) in pediatric department with complaint of generalized swelling and decreased urine output were admitted and diagnosed as case of nephrotic syndrome. Result: Mean input and urinary output over 5 days in both group A and B patients. The mean urine output in patients of group B was higher than group A with values being statistically significant for day 5 (p-value 0.04). Thus concluding that Diuretic action of Group B (frusemide- metolazone) was better than group A (frusemide-spironolactone). Conclusion: We conducted a study to compare the efficacy of frusemide- spironolactone and frusemide– metolazone combination in patients admitted in Pediatric department as a case of nephrotic syndrome having edema. Our study showed that group B had higher mean weight loss as compared to group A specially on days 4 and 5 of the diuretic therapy. Thus showing that frusemide metolazone combination had better diuretic action than frusemide spironolactone. On comparing the urine output we found that Group B had more urine output as compared to Group A particularly in days 4 and 5 of therapy. Study Designed: Comparative Study Keywords: efficacy, furosemide- metolazone, oral furosemide- spironolactone & nephrotic syndrome.