Purpose or Case Report: Urinary tract dilation (UTD) is a common finding in fetal and neonatal imaging, and accurate classification is essential for guiding management and determining prognosis. This educational exhibit provides a comprehensive review of the UTD classification system, with a focus on the findings on fetal ultrasound (US), fetal MRI and postnatal imaging. In addition to the classification system, we will explore the etiologies of UTD, including obstructive and non-obstructive causes such as vesicoureteral reflux, ureteropelvic junction obstruction, and posterior urethral valves. Special emphasis will be placed on the role of prenatal and postnatal imaging in monitoring progression and guiding management decisions, including when surgical intervention may be necessary. We aim to enhance the understanding of the diagnostic criteria for UTD, provide insight into the correlation between imaging findings and clinical outcomes, and equip pediatric radiologists with the tools to make informed management recommendations. This review will aid in the accurate diagnosis and treatment of UTD, ultimately improving outcomes for affected neonates.
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