BACKGROUNDThe congenital pouch colon (CPC) is an anorectal malformation (ARM) prevalent in northern India. There is a lot of literature available regarding its clinical presentation, classifi cation and management. The rectal atresia is also a rare entity. But, association of both these anomaly is very rare. Only three cases had been reported in the literature. Our case is the fourth one.Our case additionally had atypical features of proximal colovesical fi stula which is not yet mentioned in the literature.Exceptionally, in spite of a very large colonic pouch, x-ray abdomen had not showed any described features of CPC. The reason was a large colovesical fi stula through which all feces and air were decompressed as meconiurea and pneumaturea.