Congenital biliary dilatation (CBD), or choledochal cyst, is a cystic or fusiform dilatation of the common bile duct that is uncommon in Caucasians. There is little doubt that CBD is a congenital lesion with a strong hereditary component, which may explain the higher incidence seen in Asia, and its familial occurrence in siblings and twins.1 3 Traditionally, approximately half become symptomatic in infancy, and neonatal cases have been uncommon. However, with advances in diagnostic imaging techniques, its incidence is increasing, particularly in neonates because of an increase in prenatally diagnosed CBD.4 12 In our series, about 20% of patients were detected either neonatally or antenatally, and interestingly, the ratio of cystic to fusiform-type CBD neonatally or antenatally is 20:1, in contrast to an overall ratio of 5:3.13