Bilateral renal agenesis is a lethal congenital anomaly. It appears to
be transmitted in a polygenic pattern. The prenatal ultrasound findin
gs consist of severe oligohydramnios, absence of the fetal bladder, an
d failure to identify fetal kidneys. Twin gestations with renal agenes
is have been described in the paediatric literature. We detail a case
of a patient with two prior affected pregnancies with bilateral renal
agenesis. Her latest pregancy was diagnosed prenatally, with one fetus
with bilateral and the other fetus with unilateral renal agenesis. Th
e ultrasound findings should be differentiated from the stuck twin phe
nomenon.