"Purpose: We analyzed the clinical aspects of acute pyelonephritis patients who received hospitalization treatment and the factors to effect a therapy session. Materials and Methods: We evaluated 108 patients with acute pyelonephritis who underwent hospitalization treatment between January 2003 and May 2006. The patients were divided into two groups by history taking, radiological and laboratory finding: group A consisted of 60 patients without co-morbid condition and group B consisted of 48 patients with co-morbid conditions. Comparisons of the two groups were made using independent t-tests with hospitalized durations, uropathogen types, clinical improvement durations, laboratory improvement durations and co-morbid conditions. Results: The analysis included 108 patients with a male to female sexual ratio of 1:7.3, a mean age of 51.3±16.8 years and a mean number of hospitalized days of 9.7±9.2 days. The co-morbid conditions were hypertension in 18 patients (16.7%), LUTS in 16 patients (14.8%), and diabetes mellitus in 15 patients (13.9%). The hospitalized durations of two groups were 7.4±3.3 and 10.5±6.2 days in group A and B. The uropathogen types were all E. coli in group A, whereas E. coli, Pseudomonas and Enterococcus were isolated in group B. Clinical and laboratory improvement duration of group A was significantly shorter than group B. The longer hospitalized duration of group B was seen in chronic renal failure and diabetes mellitus patients for 10.4±5.4 and 14.0±4.3 days and the longer laboratory improvement duration of group B was seen in chronic renal failure and diabetes mellitus patients for 5.3±5.2 and 5.9±5.5 days. Conclusions: We concluded that the acute pyelonephritis with co-morbidity conditions need longer hospitalized days than that without co-morbidity conditions. Two variable (diabetes mellitus, chronic renal failure) that predicted a poor response after therapy for acute uncomplicated pyelonephritis. The more variable uropathogen were identified in a urine culture with co-morbidity conditions."