Pediatric nephrology is at a pivotal moment. As treatment advances have improved survival and clinical outcomes, families and clinicians increasingly call for a more holistic view of what it means to care well for children with kidney disease. Professional society mission statements, which emphasize a commitment to “optimal care for children with kidney disease,” offer a foundation upon which to articulate that broader vision. In this perspective, we discuss what we think optimal care is not—an exclusive focus on cure, survival, and adult outcomes—and what optimal care is: promoting the flourishing of children with kidney disease and their families.