The path with bilateral renal hypoplasia and reflux nephropathy (RVU) is characterised by particular challenges. Bilateral renal hypoplasia can occur early in life and affect kidney development. Reflux nephropathy leads to complex problems in the function of the urinary tract. Diagnosis includes imaging studies and initiates treatment strategies that may include medical or surgical interventions. Customised treatment that takes into account the unique aspects of each condition is critical for people coping with the complexities of bilateral renal hypoplasia and RVU.