Background: Congenital abnormalities in the upper urinary tract impact 20-30% of prenatal cases and range from mild alterations to illnesses requiring kidney transplantation. An awareness of these variances is critical for surgical success and patient outcomes. Aim: The purpose of this study was to thoroughly analyze and describe the anatomical variations of the upper urinary tract, with an emphasis on the kidneys and ureters, in cadavers from the central region of Tamil Nadu, India. Methodology: Thirty-five cadavers (10 adult and 25 perinatal) were dissected at K.A.P.V Government Medical College in Tiruchirappalli. The study's goal was to describe the morphology, location, and length of ureters using traditional dissection procedures. Specimens were thoroughly inspected for anomalies such as duplication, incorrect placement, and associated renal anomalies. The ureteric length from the renal hilum to the bladder was recorded. Results: Adult cadaver specimens had varying ureteric lengths (12-18 cm on the right and 12.6- 17.5 cm on the left), with abnormalities occurring in 12% of cases, including twin ureters and nonexistent kidneys. Perinatal specimens indicated developmental differences such as convoluted courses (20% of fetuses) and anomalies such as missing kidneys (one instance) and duplicate ureters (two cases). Cystic kidneys and polycystic kidney disease were among the associated kidney malformations seen in both adult and perinatal populations. Conclusion: This study emphasizes the value of detailed anatomical information in detecting and treating congenital urinary system abnormalities. The findings indicate considerable differences in ureteric morphology and related kidney anomalies, which are critical for improving surgical outcomes and patient care. More research is needed to extend awareness, particularly in different groups, which will benefit in developing better management solutions for these tough illnesses.