Background: Bladder herniation in gastroschisis is uncommon with only 19 cases reported in the literature. To our knowledge, this is the first case report of bladder perforation secondary to herniation within a gastroschisis. There is only one previous case reported of bladder perforation and gastroschisis, where the perforation was secondary to concurrent posterior urethral valves and not herniation of the bladder. Clinical Case/Discussion: A female neonate with antenatally diagnosed gastroschisis was born via spontaneous vaginal delivery at 37+2 weeks, with a birth weight of 2356g. After delivery, she had coagulopathy, hypoglycaemia and suspected sepsis and was too unstable for transfer to the operating theatre. After a period of optimisation, exploration within the NICU was performed. The gastroschisis was found to contain small bowel, the right fallopian tube, right ovary and bladder with associated perforation and necrosis of the anterior wall. The bladder perforation was closed primarily, the bladder was reduced and a suprapubic and urethral catheter were inserted. The remainder of the gastroschisis contents were placed in a silo and delayed repair was performed. Follow up renal ultrasound showed no significant abnormalities and cystogram at three weeks showed no ongoing leak. The suprapubic catheter was subsequently removed and she was discharged home. Conclusion: We present the first case of gastroschisis containing perforated bladder, successfully managed with closure and urinary diversion.