This rare congenital abnormality is found in every 40,000 births. The severity ranges from small abdominal fistula to the complete exstrophy of the cloaca resulting in the exposure of the bladder. In males there is complete epispadias with a wide and shallow scrotum. Females have wide duplication of the clitoris. Management of this condition should start at birth by covering the area with a Sialistic shield or another appropriate plastic dressings and should be urgently transferred to a surgical unit.