Congenital urinary tract abnormalities represent an important point of Paediatric Surgery. Prenatal ultrasound diagnosis has completely changed the clinical approach. Because physicians and ultrasonographers are more and more efficient, even the smallest non pathological abnormalities are detected which require less and less investigation. However, in case of moderate to severe uropathies prenatal diagnosis constitutes an effective form of preventative medicine. The postnatal management would select the less invasive method: careful follow-up or minimally invasive techniques like endoscopic procedures or video surgical procedures which are now available thanks to material miniaturization. The reconstructive surgery of the abnormal urinary tract (reflux or obstruction) are currently possible without opening the abdominal wall.