Anorectal atresia with recto-urethral fistula is one of the most common congenital anomalies afflicting the hindgut (1,2). The "H-type" ano-urethral fistula, however, is relatively rare, similar to the "H-type" tracheo-esophageal fistula which is the least common such anomaly of that region. The association of an "H-type" tracheo-esophageal fistula and an "H-type" ano-urethral fistula and stricture of the anterior urethra is considered a rare combination of anomalies. Two cases of "H-type" ano-urethral fistula with stricture of the anterior urethra and associated in one instance with an "H-type" tracheo-esophageal fistula and the other with esophageal atresia and tracho-escophageal fistula are reported and comment is made on the interesting underlying embryologic defect.
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