The podocyte is a key target of injury in a number of renal diseases. Although some current therapies—including glucocorticosteroids and calcineurin inhibitors—have potent effects on the podocyte, their effects are nonspecific and lead to unwanted systemic adverse effects. In this Review, Peter Mathieson describes how advances in our understanding of podocyte biology has enabled the identification of potential therapeutic targets that may be able to prevent or limit podocyte injury and/or promote podocyte repair or regeneration.