This is the first reported case of a trifid ureter combined with renal hypoplasia and ectopic vaginal ureter in a 12 year-old female with total urinary incontinence. A laparoscopic nephrectomy was performed and postoperatively, the patient was free of incontinence. The embryogenesis and classification of trifid ureters, and its association with ureteral ectopia and renal dysplasia are discussed. Urologists and pediatricians should consider a combination of multiple ureters, renal hypoplasia and an ectopic ureter in patients presenting with total incontinence. Early diagnosis and management of these cases result in the salvage of greater amount of kidney function and lesser morbidity.