To unveil this association, and we hypothesize that preoperative and intraoperative UTI will be correlated with postoperative UTI and sepsis occurrence. The 2020 National Surgical Quality Improvement Program Pediatric (NSQIP-P) data was analyzed for patients undergoing ureteroneocystostomy for VUR. Patients that underwent UNC for treatment of VUR with UCx obtained within 2 weeks preoperatively or on the day of surgery were identified. The patients were divided into 3 groups: no bacterial growth, bacterial growth with UTI, and bacterial growth PMG (polymicrobial growth). Patient demographics and preoperative variables were evaluated. The postoperative urinary tract infection rate of the three groups were 2.0%, 9.2%, and 9.9% for group A, B, C respectively (p<0.001). Postoperative sepsis was noted to be 0.5%, 1.3%, and 3.6% for group A, B, C (p<0.01). Additionally, there was a difference between mean operative time (p<0.001), mean length of stay (p=0.03), and mean days from operation to discharge (p<0.01). On adjusted analysis, both groups B and C had higher rates of UTI compared to group A. Group C was also seen to have greater rates of sepsis on adjusted analysis. The association found between preoperative UTI with less than 2 species of microorganisms (group B) and postoperative UTI indicates that UTI treatment and antibiotic prophylaxis should be considered when undergoing UNC for VUR. The results of this study may lead to more careful consideration of the use of preoperative and intraoperative UCx as well as treatment of UTI in pediatric patients with VUR undergoing UNC.