This document summarizes pyrimidine nucleotide metabolism. Pyrimidine synthesis involves multiple steps including formation of carbamoyl phosphate from glutamine and bicarbonate, condensation with aspartate, ring closure, transfer of ribose phosphate, decarboxylation and phosphorylation to form UMP. UMP is further converted to UDP, UTP, CTP and TMP. Pyrimidines can also be synthesized through a salvage pathway using preformed bases. The synthesis is regulated by feedback inhibition of key enzymes by end products. Disorders include orotic aciduria due to deficiencies in the pyrimidine synthesis pathway and Reye's syndrome which involves secondary orotic aciduria.