Background: Focal segmental sclerosis (FSGS) is a common cause of nephrotic syndrome in adults and children that characterized by scar tissue formation in the glomeruli, which are responsible for blood filtration [1]. Focal segmental glomerulosclerosis (FSGS) is classified into two main categories: 1. Primary (Idiopathic) FSGS: This form of FSGS has no identifiable underlying cause. It occurs spontaneously and is thought to be related to genetic factors or immune system dysfunction. 2. Secondary FSGS: Secondary FSGS results from other conditions or factors that damage the glomeruli. These underlying causes can include obesity, infections, drug toxicity, kidney diseases (such as HIV-associated nephropathy), and certain systemic diseases [2]. In advanced stages, dialysis and kidney transplantation will be required. One of common treatments include immunosuppressive drugs, but they often do not provide a definitive cure and can have side effects due to immune system suppression [3]. Case presentation: In this article, we present a boy who was 13-year-old who sought medical attention due to kidneys pain and red-colored urine. The physician diagnosed it as focal segmental glomerulosclerosis, treated with antibiotics and immunosuppressants. Unfortunately, this approach proved ineffective, leading to the progression of the disease to severe stages, necessitating a kidney transplant. However, our medical team took a different approach. We combined traditional herbal remedies to halt the disease progression. Remarkably, this holistic treatment not only eliminated protein and blood in the urine but also completely reversed the FSGS. Upon reviewing new test results and conducting clinical consultations, the previous treating physician, who had recommended the kidney transplant, concluded that neither the transplant nor their previously prescribed medications were necessary anymore. Conclusion: Focal segmental glomerulosclerosis, which can occur due to infection and genetic factors, often has a limited response to standard treatments. This severe kidney disease, leading to renal inefficiency in many cases, may necessitate dialysis and kidney transplantation. In this particular case, at the request of patient’s parents, we prescribed a combination of herbal remedies that were used for 45 days and caused remarkable results. Now, after 7 years of treatment, the patient's kidney functions effectively without any issues , with no presence of protein or blood in the urine.