The purpose of this review paper is to provide a summary of recent developments in the childhood disorders of renal phosphate-wasting, with particular emphasis on two of the hereditary conditions, X-linked hypophosphatemia (XLH) and autosomal dominant hypophosphatemic rickets (ADHR), as they are distinguished from the paraneoplastic syndrome, oncogenic hypophosphatemic osteomalacia (OHO). An overview of the clinical manifestations, pathogenesis, diagnosis, and treatment of these conditions, with attention to newly-discovered genetic and hormonal signatures, will be discussed. The information may be invaluable in the complex diagnosis and successful treatment of OHO and hereditary hypophosphatemias of childhood.