We hereby describe the technique and our experience of a single-staged repair of bladder exstrophy and epispadias in two newborn males. The combined repair improves dissection and exposure of the bladder neck, posterior urethra and prostate, allowing better exposure for reconstruction and proper positioning in the pelvis. This approach should be avoided in premature babies and in patients with a very small penis. Although the complication rate of this procedure is low, large experience and expertise in exstrophy and epispadias is imperative prior to embarking in this major neonatal reconstruction.