A three-day-old female child presented to us with abdominal distension and lower limb swelling. On ultrasound examination, there was a cystic mass contiguous with the uterus in the lower abdomen and pelvis which showed fluid- debris level. This mass was causing displacement of the urinary bladder anteriorly. MRI confirmed the findings of ultrasound. A diagnosis of hydrometrocolpos secondary to imperforate hymen was made following physical examination. Neonatal hydrometrocolpos is a rare condition which requires a high index of suspicion for diagnosis. Hydrometrocolpos refers to the accumulation of secretions within the endometrial and endovaginal canal. Diagnosis can be made prenatally or post natally using ultrasonography and magnetic resonance imaging. Early diagnosis reduces the incidence of complications.
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