Aim: the aim of this study to evaluate the kidney structure and function in dilating vesicoureteral reflux patients with anorectal malformation. Materials and methods: This is a retrospective study based on the Author's personal experience and cases operated in the Department of Paediatrics surgery Patna Medical College and Hospital, Patna Bihar, India for 10 year. Total 150 consecutive VUR >grade III (dilating VUR or D-VUR) patients include in this study. Subjects were divided into two groups according to the presence of ARM to give ARM+ (n=20; 30 ureters) and ARM– (n=100; 120ureters). Results: The differences between ARM+ and ARM– for sex distribution (male: 55% vs 62%), mean incidence of all UTI (including preoperative) per patient (2.1±1.7vs 2.6±1.9), incidence of bilateral D-VUR (20% vs 38%) or mean overall duration of follow-up [defined as the period from the initial consultation to the final consultation at our institute; 6.4±1.3years andgrades of D-VUR were not significant. The incidence of BBD in ARM+ was significantly higher than that in ARM– (40% vs 10%; p=0.0007). However, differences in the mean ages of BBD patients with respect to ARM were not significantly different [7.2±2.4 years forARM+versus7.5±2.2yearsfor ARM–, p=0.62]. DMSA scans indicated that both severe multiple and diffuse renal cortical lesions (RDS: 2m, 2d) were identified significantly more often in ARM+ than in ARM– (65% versus 30%, p=0.042). Conclusions: we concluded that the renal cortical lesions were correlated with grade of DVUR in ARM– and RDS was significantly higher in ARM+, BBD did not appear to contribute to progressive renal dysfunction as is commonly believed.