Whilst congenital anomalies of the urinary and reproductive tract are uncommon, advances in medicine have resulted in much improved survival into adulthood and relatively normal life expectancies. This has created a large group of patients who need lifelong multi-disciplinary care, and transition from paediatric to adult services is the pivotal point in determining future engagement with clinicians and ultimately patient outcomes. The challenges are numerous and multi-factorial. In this chapter, we will review traditional teaching, historical data and the most up-to-date evidence in this fascinating field of medi cine.