In this episode, we explore the clinical roadmap for life long gynecologic care in patients born with anorectal malformations (ARM). Drawing from consensus guidelines by the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC), we discuss the high prevalence of associated Müllerian and gynecologic anomalies—which affect 17% to 67% of patients with ARM and up to80% of those born with a persistent cloaca. We outline a standardized, multidisciplinary framework to address critical patient needs across their lifespan, including adolescent screening, menstrual management, sexual health, fertility, and the transition to adult medical care.