A 29 year old nulligravid, married for 11 years sought consult due to recurrent urinary tract infection and primary infertility. Physical examination revealed a dilated urethral orifice accommodating two fingers and a blind vaginal pouch 0.5 cm deep with a pinpoint opening at the apex. The septum was excised and the dilated urethra repaired. Patient became pregnant two months after the operation and subsequently delivered via low transverse cesarean section to a 3700 gram baby. Surgical resection is the treatment of choice and postoperative dilation may be necessary to prevent restenosis. Outlook for pregnancy is encouraging and the mode of delivery must be based on individual circumstances.?