Aim: Ultrasound is the favorite method for follow-up of urachal remnants when conservative management is chosen instead of surgical resection. However, the success of conservative management depends on the type of urachal anomaly, and the agreement between sonographic and pathoanatomic diagnoses has not yet been assessed. Material and methods: We retrospectively included all minors treated for a urachal anomaly at two German pediatric surgical centers between January 2008 and December 2020. Ultrasound examinations were conducted by specialized pediatric radiologists and compared with pathoanatomic reports following resection of the urachal anomaly, with respect to its type. Results: We included 15 patients with a median age of 0.2 years. The crude agreement between ultrasound and pathoanatomic diagnosis was 70%, and Cohen’s κ was 0.66 (95% confidence interval: 0.3 – 1, z = 3.83, p <0.001). Conclusions: Ultrasound identified the type of urachal anomaly with sufficient accuracy in this cohort; however, these findings should be corroborated by a substantially larger study.