A 31-year-old woman, gravida 2, para 1, was referred to our hospital at 18 weeks of gestation for level II ultrasound examination due to severe oligohydramnious. Ultrasound examination showed bilaterally enlarged echogenic kidneys (ratio of kidney circumference to abdominal circumference=0.53, 6 SD above the normal mean) with their reniform shape and severe oligohydramnious. Autopsy revealed symmetrically enlarged kidneys with multilocular cystic changes, which was consistent with the prenatal ultrasonographic finding. However, absence of the bladder was detected incidentally. In addition, both ureters showed blind-endings without any other ureteral openings. In this case, we overlooked the nonvisualization of bladder as a usual ultrasonographic finding of autosomal recessive polycystic kidney disease (ARPKD). Chromosomal analysis revealed a 46,XY karyotype. Renal ultrasound examination of parents was revealed as normal. Here we present our experience of a case of ARPKD associated with the agenesis of the bladder with brief review of literature. The Korean Journal of Ultrasound in Obstetrics and Gynecology 10(3):140-144, 2008