Multicystic renal dysplasia in a crossed fused or nonfused ectopic kidney is a rare occurrence that produces unusual imaging findings. In four such cases in neonates, three presented with a palpable abdominal mass and one was discovered in utero with maternal sonography. In three cases, sonography showed a multicystic mass, contiguous with the lower pole of the orthotopic kidney. In the fourth infant, a crossed, tiny dysplastic kidney was not visualized, but its markedly dilated ectopic ureter was seen traversing the spine on CT. Ureteropelvic junction obstruction was present in the three fused orthotopic kidneys. The characteristic imaging findings of multicystic dysplasia and crossed renal ectopia include a multicystic mass of variable size that is contiguous with the lower pole of a hydronephrotic, malrotated kidney; ureteral displacement and/or dilatation; and contralateral absence of the kidney and its renal artery.