Prune Belly Syndrome (PBS) is a rare congenital condition, occurring in approximately 3.8 per 100,000 live births, with 95% of cases affecting males. It is characterized by a triad of abdominal wall muscle deficiency, urinary tract anomalies, and cryptorchidism. PBS often results in poor neonatal outcomes due to complications such as pulmonary hypoplasia, renal failure, and other congenital anomalies. o discuss the challenges posed by PBS, particularly in low-resource settings where antenatal care (ANC) is inaccessible, and its association with obstructed labour and poor perinatal outcomes. A detailed review of a clinical case involving PBS and obstructed labour, supplemented with a discussion of existing literature on the syndrome's incidence, prognosis, and the role of antenatal screening. The prognosis for PBS remains poor, with high rates of stillbirth and early neonatal death. Routine use of anomaly screening has improved early detection and enabled better management, but lack of access to ANC in rural areas contributes to severe complications such as obstructed labour. Emergency cesarean sections may be required for delivery, but they do not mitigate the poor outcomes associated with advanced fetal anomalies. The case highlights the critical need for universal access to antenatal care and routine fetal anomaly screening. Early detection of PBS can enable informed decision-making and improve maternal and neonatal outcomes. Efforts must focus on addressing healthcare disparities in rural and underserved areas to reduce the burden of perinatal mortality associated with conditions like PBS