Massive fetal ascites is unusual and, while having diverse mechanisms, is most frequently due to obstructive uropathy. A rare form of urinary tract obstruction, complete urethral atresia with complex urogenital tract anomalies, is anatomically documented in the following case report. In addition, concurrent cytomegalic inclusion disease, also rarely associated with fetal ascites, was present. Unlike the present case, some more common forms of neonatal urinary tract obstruction are amenable to surgical relief. For this reason, the level of obstruction is clinically important.