Introduction. In the groups of patients with anorectal malformations (ARM) was marked a phenotypic variability, with the coexistence of reno-urinary anomalies in 30-40%, simultaneous evolution of which causes the worsening of the somatic status, limits the possibilities of radical surgical treatment, increases the incidence of postoperative morbidity. Aim of study. Evaluation of incidence and impact of congenital reno-urinary anomalies associated with ARM. Material and methods. The medical records of 54 children born with an ARM in the period 2018-2022 were retrospectively studied in our clinic: documentation of diagnosis, screening method, urological anomalies, treatment, complications. Results. The overall incidence of urological anomalies was recorded in 24% of cases: in 9,26% - congenital hydronephrosis; 3,70 %- hypospadias; 3,70%renal agenesis; 3,70%- deformation of the scrotum. Also, in 27,7% of all cases was determined a rectourethral/ bladder/ prostatic fistula. Presence of the urological anomalies in patients with ARM there are a predictive factor for the occurrence of septicoinflammatory processes of the reno-urinary system which negatively influences the somatic status of newborns and also delayed the stages of surgical correction of anorectal malformations. Conclusions. Urological anomalies are frequently seen in patients with ARM. The presence of concomitant pathologies explains the necessity of the amount of invasive treatments these patients require, but timely identification of newborn with ARM reduce risk of renal failure and may be significant for renal survival.