Background: Urethral Prolapse is a rare benign condition that is often misdiagnosed by clinicians. Objectives: To report the clinical presentations and outcomes of urethral prolapse in Nigerian pre-menarcheal girls and to review the literature. Methods: This retrospective study was undertaken from February 21, 2015 back to January 1st, 2010. The clinical presentations and outcomes of cases of urethral prolapse managed in Enugu with complete surgical excisions were reviewed. Results: There were five cases of pre-menarcheal urethral prolapses. Their ages ranged from 2 to 10 years with a mean age of 6.6 years. The case presentations were mass in the vagina (4/5, 80%), asymptomatic (3/5, 60%), bleeding per vagina (1/5, 20%), and dysuria (1/5, 20%). Four cases (4/5, 80%) were misdiagnosed with the parents suspecting sexual assault in 3 (3/5, 60%) children. The outcomes of the surgical excisions were uneventful in four (4/5, 80%) cases. One child (1/5, 20%) had postoperative acute retention of urine. There was no urinary incontinence or recurrence of urethral prolapse after the excisions. Conclusions: Urethral prolapse is rare and often misdiagnosed by clinicians. The outcomes of complete surgical excisions were uneventful in most cases.