Tailgut cysts are rare congenital lesions that typically manifest as a presacral, retrorectal, multicystic mass. Even though they are derived from remnants of the embryonic tailgut, they most often present in women. Differential diagnosis includes rectal duplication cyst, sacrococcygeal teratoma, and anterior meningocele. Treatment demands complete excision to prevent infection and malignant degeneration. Fewer than 20 pediatric cases have been reported. Two further affected children are described, one of whom presented uniquely with urinary tract obstruction and acute renal failure.