Congenital anomalies that result in vaginal obstruction usually present either in adolescence, with primary ammenorrhoea or less often in the neonatal period as a cystic lower abdominal mass, causing bladder and rarely rectal outlet obstruction. Hydrometrocolpos could be secretory or urinary according to the type of fluid that collects, either mucus or less often urine respectively.1 Because of high incidence of associated anomalies like postaxial polydactyly, congenital heart disease, retinal dystrophy or retinitis pigmentosa renal anomalies, complete evaluation should be under taken before definitive surgical treatment. The appropriate treatment has shown a long-term success and has resulted in proper psychosocial and sexual maturation.