Abstract Ninety four children with exstrophy of the bladder treated by ureterosigmoidostomies were evaluated from five to thirty-five years after surgical treatment. Thirty-nine patients were followed twenty or more years, and 87 per cent were alive at the end of the study period. Eight children who died of renal failure, one to thirty-two years after surgical treatment, were lost to follow-up with no intravenous urogram obtained for as long as ten years. Of the 34 children treated surgically since 1954, 33 are alive, 28 are functioning with ureterosigmoidostomies and 5 have had conversions to ileal conduit. Intravenous urogram results are normal in 25 of these 28 patients. Sixty-four patients are now over twenty years of age, 26 are married, and nine are the parents of 13 children. The majority of these are well-adjusted, productive persons.