For early detection of unilateral occlusion of duplicated müllerian ducts, serial pelvic sonography was performed in 215 girls with known renal agenesis, especially following menarche, during the last 6 years. To date, 16 girls with unilateral occlusion of duplicated müllerian ducts were detected. We stress the value of this modality, which can lead to a prompt diagnosis, and allow for early and appropriate surgical intervention.