Bilateral renal agenesis (Potter syndrome) in the neonate is incompatible with life. Unfortunately, these infants are often delivered by cesarean section, as premature labor and breech presentation are commonly associated with the condition. In reviewing the obstetric course of 6 women who recently delivered such babies, the authors have found that antepartum diagnosis is possible in most cases. Specifically, vaginal delivery should be strongly considered for patients in premature labor with intact membranes and breech presentation when there is ultrasound evidence of an abnormally shaped fetal head, absence of the fetal bladder, and severe oligohydramnios.