Due to rectal atresia a 10-year-old boy had been operated on using Rehbein's procedure in babyhood in another hospital. Rectal incontinence remained and we planned to improve it by a gracilis plastic operation. During preoperative diagnosis we found a so-called "Currarino triad", because the boy did not only have an anorectal malformation but also an anterior sacral meningocele and a solid presacral tumour. Initially, two surgical interventions were done to remove the tumour and meningocele and three months later a gracilis plastic operation was performed successfully.