Ureteral duplication is one of the most common malformations of the urinary tract, affecting 1 in 125 children (0.8%). Duplication can be complete or partial. A bifid renal pelvis includes only a single ureter, but confluence of the upper and lower ureters below the ureteropelvic junction (UPJ) and above the bladder constitutes partial duplication of the ureter or bifid ureter. Partial duplication does not predispose to vesicoureteral reflux (VUR), and surgical correction is based on the same indications as a single refluxing ureter. In contrast, complete ureteric duplication may be associated with UPJ obstruction, VUR, ureteral ectopia and/or ureterocele. This chapter will focus on management of vesicoureteral reflux in the setting of complete ureteral duplication.