During a period of fifteen years, 9 children and 5 adults with a variety of urachal anomalies were treated. Infected urachal cysts were more common in children whereas adults more frequently had infected urachal sinuses. After careful physical examination, a preoperative diagnosis could be made in most patients, with ultrasound examination decisive in doubtful cases. Whenever feasible, complete excision of the umbilicovesical tract is performed, but in very ill patients, a staged treatment becomes necessary. The preoperative injection of methylene blue is helpful in the identification of communicating tracts, all of which should be removed. All affected children should undergo investigation for associated genitourinary anomalies.