The abdomino-perineal-vaginal pull-through operation offers the most anatomically correct reconstruction for patients with vaginal atresia. A 14-year-old girl with vaginal atresia and a persistent urogenital sinus underwent genitourinary reconstruction using this technique. Years later, two planned pregnancies were carried to term and completed by elective cesarean delivery. This is the first case that demonstrates normal vaginal function following abdomino-perineal-vaginal pull-through.