Introduction: Malformative uropathy (MU) is a common reason for consultation in paediatricuronephrology. The circumstances of discovery vary according to age, and the prognosis depends on the type of malformation observed. Objectives: The aim of this study is to assess a twenty-year period of follow-up of malformative uropathies, studying the epidemiological, clinical, therapeutic, and evolutionary aspects in a general paediatrics department in Algiers. This is a retrospective study conducted on children with malformative uropathy between January 1, 2001 and December 31, 2019. The study examines their epidemiological, clinical, paraclinical, and evolutionary profile. Out of 223 selected files, 194 were analyzed. Results: The study found a sex ratio of 1.7, indicating a male predominance across all ages. The mean age at diagnosis was 23 months (ranging from 1 day to 15 years), with 116 patients (59.8%) being less than 12 months old. More than half of the cases (53%) were diagnosed before the age of six months. Urinary tract infections were the most common circumstances of discovery, accounting for 50.5% of cases. Antenatal diagnosis was only found in 32.4% of cases. In this study, it was found that one-third of the patients had vesicourethral reflux disease (VU) (33%), 26.8% had megaureter (MU), pyeloureteral junction syndrome (PJS) was present in 24.2% of patients, while posterior urethral valves (UPV) accounted for only 6.2% of cases. VUR remains the most benign uropathy with a spontaneous cure rate of over 66%. Regarding renal function, it is disrupted in severe bilateral forms, particularly in patients with posterior urethral valves. It was concluded that malformative uropathies are relatively frequent, mainly obstructive pathologies, and they cause a third of chronic kidney failure in children. The prognosis of malformative uropathy is primarily determined by early diagnosis, the type of uropathy, and appropriate management. The study focused on vesicoureteral reflux and antenatal diagnosis. This study was conducted by the Department of General Pediatrics at Children's Hospital.