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Crossed fused renal ectopia is a rare congenital anomaly of renal embryogenesis. The majority of such anomalous kidneys are supplied by a single renal artery and drained by two separate ureters. However, drainage by a single common ureter is an unusual variant. Here, we present a 17-year old male with a pelvic pancake kidney drained by a single ureter with associated acute obstructive uropathy diagnosed with ultrasonography and computed tomography urography (CTU). We describe the anatomical peculiarity and diagnostic evaluation of the case.