Neonatal urological emergencies are uncommon in the general pediatric practice but require highly complex medical infrastructure and a multidisciplinary approach. This chapter describes the most common urological neonatal emergencies that require immediate or early surgical intervention by the pediatric urologist and the multidisciplinary team. The majority of these conditions are detected on routine antenatal ultrasound. The pathophysiology of neonatal testicular torsion is "extravaginal" torsion of the tunica vaginalis including testicle and epididymis. Inter-labial masses may not always require an emergent consultation for the pediatric urologist. Nonetheless, given the differential diagnosis of possible malignancy or conditions requiring surgical management, it is imperative that these patients are seen as soon as possible. A careful physical examination may be sufficient to make an accurate diagnosis.