Transverse vaginal septum results when the vaginal plate, formed from the fused sinovaginal bulbs fails to break or canalize during the embryogenesis.1 It may occur anywhere within the vagina, but most frequently at the junction of the cranial and middle third. It has an estimated prevalence of about 1 in 75,000 women.2 A complete septum produces obstructive symptoms similar to an imperforate hymen without bulging of the introitus. A partial septum allows passage of menstrual flow but causes dyspareunia, foul smelling vaginal discharge or laceration during childbirth. This report has demonstrated the restoration of the normal anatomy of a 13 year old presenting with complicated transverse vaginal septum with bilateral hematosalpinges. The technique was a simultaneous ultrasound-guided drainage of hematocolpos combined with perineal-abdominal approach. Management is best if diagnosed at an early age to obtain favorable outcome and to prevent psychological problems that will arise at a later age.