Congenital obstructive uropathies represent a group of developmental urological disorders that impede urine flow. They are also the most common cause of renal failure in children. If not recognized and treated in a timely manner, they disrupt the development of the urological system as well as the overall growth and development of the fetus. Antenatal ultrasound scans display obstructive uropathies as dilation of the renal pelvis and ureters, with the most common causes being pelvic-ureteral junction stenosis, vesicoureteral reflux, and posterior urethral valves. Endoscopic techniques, such as ureteroscopy, are minimally invasive procedures that can effectively treat certain cases. On the other hand, reconstructive surgeries involve surgically removing the cause of the obstruction and establishing anastomosis to maintain proper urine flow. Open surgical methods are indicated in more complex cases or when other interventions have not been successful. In certain cases, fetal surgery may be considered, which is performed during pregnancy to alleviate the obstruction and promote healthy fetal development. These treatment methods play a crucial role in preserving kidney function. Understanding the different surgical procedures and their indications is crucial for providing optimal care to patients and achieving positive treatment outcomes.