Introduction Somatosensory evoked potential (SSEP) and urody-namic studies (UD) are valuable tools for assessing patients with closed spinal dysraphism (CSD) before neurosurgical intervention. No studies have corre-lated their findings in this cohort and our aim is to study their correlation and prognostic value in pe-diatric patients with closed spinal dysraphism. Methods Retrospective review of all patients referred to a multidisciplinary clinic in a tertiary pediatric surgical center over a 17 years period between April 2004 to September 2021 was performed. Inclusion criteria were <18 years old, diagnosed with CSD, with SSEP and UD done within 1 year of each other. De-mographics data collected include age at presenta-tion/at referral/at neurosurgical operation, gender, symptoms at presentation and intra-operative di-agnoses. Pre-operative SSEP and UD findings were documented. Primary outcome was UD results in the group with normal and abnormal SSEP. Secondary outcome was urological and bowel function outcome in 4 groups of patients (Group A-both normal SSEP and UD, Group B-abnormal SSEP only, Group C -abnormal UD only and Group D-both abnormal SSEP and UD). Results A total of 45 patients were included for analysis. Mean follow up time was 118.9 months (24-216 months, SD 55.8 months). SSEP was normal in 20 patients and abnormal in 25 patients. Baseline demographics, preoperative symptoms and imag-ing were similar between 2 groups. Primary outcome Patients with abnormal SSEP were more likely to have abnormal UD results with a statis-tically significant difference (84% vs 40%, p < 0.05). They have a significantly higher end-fill detrusor pressure (12% vs 0%, p < 0.05), abnormal bladder compliance (20% vs 0%, p < 0.05), abnormal cystometric capacity (48% vs 10%, p < 0.05), poor emptying efficiency (24% vs 5%, p < 0.05) and sphincter incompetence (8% vs 0%, p < 0.05). Secondary outcome When compared to Groups A to C, patients in group D were more likely to be on anti-cholinergic (33.3% vs 4.3%, p < 0.05), required clean intermittent catheteri-zation (42.9% vs 4.3%, p < 0.05) and had intra-vesical botulinum injection (19% vs 0%, p < 0.05). All the patients who had augmentation cys-toplasty were in this group as well. Bowel func-tion in terms of regular enema use was also statistically significantly higher in this group (33.4% p < 0.05). Conclusion Pre-operative SSEP and UD results correlate well in patients with closed spinal dysraphism. Patients with abnormal SSEP and UD preoperatively have higher risk of urological deterioration over time. Close monitoring in this group is warranted.