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There are few publications studying the impact and cost benefit relationship of electron microscopy in the diagnosis of glomerulopathies in routine service. The aim of this study is to assess the contribution of EM to the final diagnosis of renal glomerular diseases in Egyptian patients. Retrospective evaluation of 120 renal biopsy specimens received for primary diagnosis at EM center of Ain Shams university Specialized hospital, Cairo Egypt during 2007 in the knowledge of light microscopic, immunofluorescence and electron microscopic findings. It was found that EM was essential for diagnosis in 25% of renal biopsies, corresponding to 100% of hereditary glomerulopathies and 23.5% of other glomerulopathies, It was useful to the diagnosis in 41.67% of the cases, confirming the preliminary diagnosis. In 33.33% of cases EM was considered unhelpful in diagnosis. It's concluded that the importance of EM has not decreased during the last years. New glomerular diseases and variants can be diagnosed only by EM as fibrillary glomerulonephritis and immunotactoid glomerulopathy. Routine evaluation of allograft biopsies should include EM to achieve better recognition of capillary lesions of chronic rejection. EM provides useful diagnostic information in about 66% of native renal biopsies. Kidney biopsy protocols should include EM in all biopsy cases. If electron microscopy cannot be performed routinely on all such biopsies, tissue should be reserved for EM studies.