An infant with pneumaturia and fecaluria was found to have a rectal duplicatation with a fistula between the duplicated rectum and the urethra. Rectal duplication, although rare, should be considered in cases of bizarre lower bowel symptoms in children. Correction in our case was effected by exclusion of the duplicated segment along with removal of its mucosal lining and division of its urethral fistula. The termination of the duplicated rectum in the urinary tract, as in cases of imperforate anus, suggests a related embryologic mechanism for the 2 types of anomalies.