Objective: The purpose of this study was to describe a case of day time incontinence due to Urethro vaginal reflux. Methods: This is a case report of a 18 yr old girl who had presented to the out patient department with day time incontinence and post void dribbling. Ultrasound suggested an urethral diverticulum but the actual diagnosis was arrived by performing a MCU which is suggestive of a Urethro Vaginal reflux. Results: She improved significantly by proper toilet training and is predominantly dry at 1 yr follow-up. Conclusions: Urethro vaginal reflux can produce vaginal distension that is sonographically identical to obstructive hydrocolpos and may present with day time incontinence in young girls. This may be due to dysfunctional voiding issues. Postvoid sonography allows proper diagnosis and it can be treated by early clinical suspicion, proper diagnosis and advice