Prune-belly is a figurative term for the wrinkled appearance of the abdomen resulting from agenesis of the abdominal musculature, which is invariably associated with abnormality of the urinary tract and less often with malformation of the heart, malrotation of the gut and talipes equinovarus. This rare syndrome is almost entirely limited to males, and death in childhood is common from recurrent urinary infections. The absence of abdominal muscles weakens the ability to cough and consequently there is a tendency to recurrent respiratory infections. Moreover, the mechanics of pulmonary ventilation are abnormal in this condition and the problems which may confront the anaesthetist are illustrated by a case report.