Abstract
Anterior rectal duplication cyst is rare entity with <50 reported cases to date. It has myriad presentations like bleeding per rectum, constipation, rectal prolapsed and intestinal obstruction due to extrinsic compression of rectum. However, the association of enlarged duplication cyst compressing the bladder neck or ureter, and leading to bladder outlet obstruction or hydroureteronephrosis is extremely rare with only a handful of reported cases. We report a rare case of large anterior rectal duplication cyst in a young girl leading to acute urinary retention with bladder outlet obstruction which was eventually managed by laparoscopic-assisted transabdominal surgical excision of the cyst. The authors believe that such an association has not been previously reported in this age group.