Abstract
Congenital perineal groove is a rare, often under-recognized anomaly of the anogenital region, characterized by a non-keratinized mucosal sulcus extending from the posterior vaginal fourchette to the anterior margin of the anus. We report a term female neonate weighing 2.9 kg, born via normal vaginal delivery to a primigravida mother after an uneventful perinatal period, in whom a mucosal groove was noted extending from the posterior vaginal fourchette to the anal verge during routine examination. A perineal tear was initially suspected; however, the uncomplicated delivery argued against this diagnosis. A literature review confirmed the finding as a congenital perineal groove - a benign developmental anomaly. Recognition of this condition at birth is crucial to avoid misdiagnosis as perineal trauma or ambiguous genitalia. Conservative management with meticulous local hygiene and regular follow-up remains the mainstay of treatment; surgical correction is reserved for persistent or complicated cases. Awareness of this rare yet benign entity among clinicians ensures accurate diagnosis, appropriate counseling, and optimal management.