Abstract: The present study was planned to evaluate the serum levels of tissue factor and factor VIIa of nephrotic children and to investigate the possible alteration in their levels in relation to heparin treatment and disease activity. The study included 40 patients with nephrotic syndrome, further divided into 2 groups and 15 controls. Group IA included 20 nephrotic patients and received low molecular weight heparin beside steroid therapy. Group IB included 20 nephrotic patients and received steroid therapy only. The patients were evaluated initially, one week and one month from the commencement of therapy. At the start of study, tissue factor and factor VIIa levels showed no significant difference between group IA and group IB, while both patients` groups showed significantly higher tissue factor and factor VIIa as compared to the control group. At day 7, the study revealed obvious clinical improvement accompanied by significant decrease in tissue factor and factor VIIa in group IA as compared to group IB. Moreover, the laboratory improvement was more marked after 30 days of follow up. Also, steroid dependent and resistant nephrotic patients of group IA had comparable serum tissue factor and factor VIIa with control group at day 30 of the study. Time to achieve remission was significantly shorter in steroid resistant patients of group IA as compared to those of group IB. There was no significant difference in time to remission in both steroid dependent subgroups. Therapy with low molecular weight heparin led to decrease in serum tissue factor and factor VIIa and led to significant clinical improvement in the course of nephrotic syndrome in the form of shorter time to induce remission.