Late termination of pregnancy is feasible in India after the amendment of the almost 50-year-old Medical Termination of Pregnancy Act of 1971, as the gestation age limit has been removed in cases of substantial fetal abnormalities. Such cases need to be thoroughly reviewed by the medical board and the combined decision must be taken along with informed consent of the parents. We came across a woman who developed rapidly progressive fetal lower urinary tract obstruction in the late second trimester of her pregnancy. We report the complete protocolized workup of such cases irrespective of gestational age, challenges in prognostication, and the decision for medical termination.