Bladder exstrophy surgery entails much more than bladder and urethral reconstruction. There are additional anomalies of the urinary tract and pelvis that are related to the embryologic deformity. These include, but are not limited to, vesicoureteral reflux (VUR), inguinal hernia, and cosmetic restoration. These will require or benefit from surgical repair. In this chapter, we describe additional surgical procedures that often accompany the bladder exstrophy/epispadias repair. These additional procedures can be done simultaneously with the initial repair or at a later elective date.