This study aims to demonstrate the versatility and safety of conjoined ureteric reimplantation (CUR) in addressing various lower tract problems of complicated renal duplexes, including VUR, ureteroceles, ureteric obstruction and ectopia. Retrospective analysis of 66 children with complicated duplexes undergoing CUR between June 2008 - June 2018. Median post-CUR follow-up was 42 months. Data collected included: Demographics, CUR indications, pre and post-operative sonographic characteristics, UTI, moiety function, VUR, continence, hypertension and need for subsequent surgical procedures. CUR was performed primarily in 59 children. Twenty-eight had high grade VUR, 15 had ureteroceles plus high grade VUR, 8 had ureteroceles only. Eight had obstructed or ectopic ureters. CUR was performed secondarily in 7 children who despite previous duplex system surgery, had ongoing infection due to residual VUR, punctured ureteroceles or residual upper and lower-moiety ureteric stumps. Forty-two patients (63.6%) had pre-operative febrile UTI, but post-CUR, 23 (54.8%) of these had no further UTI. Overall post-CUR non-febrile UTI rate was 34.8%. Forty-one of 47 patients (87.2%) had improvement/resolution of hydro/ureter post-CUR. Of the 55 patients >3.5 years of age, post-CUR lower urinary tract dysfunction symptoms occurred in 3 patients (5.5%). All moiety function was preserved. Additional surgery post-CUR was required in 3 cases (4.5%): for laparoscopic excision of poorly-functioning dilated lower-moiety and ureter for ongoing pyuria despite CUR; for lower moiety PUJ obstruction; and finally for heminephrectomy of dysplastic upper-moiety associated with hypertension. CUR is a safe and versatile technique to effectively reconstruct and address lower tract problems associated with complex duplexes. Dilated upper tracts decompress well without impairment of moiety function, UTI risk reduction is provided, continence is preserved and further surgery is rarely required following CUR.