Purpose <p>Posterior urethral valves (PUVs) are the most common cause of bladder outlet obstruction in male infants and are associated with significant renal and bladder morbidity and long-term outcomes. This study evaluates the long-term renal and vesical outcomes and the impact of time of diagnosis in patients with PUV managed at a single tertiary centre.</p> Methods <p>A retrospective analysis was conducted on 29 patients diagnosed with posterior urethral valves (PUVs). Patients were categorised based on the timing of initial resection of PUVs: those diagnosed or treated within the first year of life were classified as early, while those diagnosed or treated after 1&#xa0;year were classified as late. Long-term outcomes were assessed to evaluate differences between early and late diagnosis groups.</p> Results <p>In this study, 12 out of 29 patients (41.38%) had late diagnosis while the remaining 17 patients were diagnosed early (58.62%). There were no statistically significant differences between the early and late diagnosis groups in terms of upper urinary tract dilatation, urinary continence, bladder function, or the presence of residual valves. At follow-up, structural renal and bladder anomalies persisted in 50% and 13.8% had compromised renal function. Urinary continence improved with 36.7% being incontinent at 1-year post-surgery to 27% at 5&#xa0;years post-surgery.</p> Conclusion <p>Structural bladder and renal abnormalities persist despite surgical interventions, indicating the need for long-term follow-up. Time of detection did not have a&#xa0;bearing on long-term outcomes. Multidisciplinary care focusing on both functional and anatomical outcomes is crucial to optimise quality of life.</p>