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Posterior urethra valve is one of the few urological condition that require early diagnosis during antenatal life and early antenatal intervention. Misdiagnosis or delay in treatment would leads to progressive renal deterioration and finally end stage hydronephrosis.The objective of the study was to determine presentation and early surgical outcome in late presenting PUV among children seen at KCMC from January 2008 to October 2015. This was a descriptive cross-sectional hospital based study. It involved patients presented in the Institute of Urology at KCMC confirmed to have PUV, and operated during the period of study from January 2008 to October 2015.Surgical complications noted were urethral stricture 1(2.4%) patient, residual valve 3 (7.5%) patients and urinary incontinence in 2 (4.9%) patients. Post vesicostomy was initial treatment, 3 (10.3%) had vesicostomy stenosis, (3.4%) bladder prolapse and 2 (6.9%) died. Cold knife has lesser complications when compared to electrofulgration in which 2 (7.4%) had residual valve, 2 (7.4%) had urethral stricture and one (3.7%) developed urine incontinence after electrofulgration.