BACKGROUND Myelomeningocoele is a common birth defect with significant lifelong morbidity. There are strong associations with folate deficiency and maternal illiteracy. There are controversies in the literature on superiority of either early or late repair. But early repair has the advantages of reducing posterior fossa abnormality and brain stem herniation and consequently hydrocephalus. We observed certain issues that preclude early repair in our locality such as majority of the patients being delivered at home under septic conditions, delay in presentation occasioned by sociocultural practices and neonatal anaesthetic underdevelopment in our centre. We therefore ask: is there an advantage in patients’ before and after 30 days of life given the advantages of wound care, antibiotic therapy and general care tailored towards the symptomatology of a patient who presented within the first 30 days of life? Aim of the study: To compare short term treatment outcomes of myelomeningocoele patients at the Regional Centre for Neurosurgery, Sokoto Patients and Methods: prospective cohort study of 90 patients who presented and were operated at the RCNS, Sokoto between September, 2015 and December, 2016. Data were collected through a structured questionnaire and analysed using SPSS 21 version. Results: ninety patients recruited into this study with male: female ratio of 1:1 and mean age of 102+213 days at presentation. Most patients (93.3%)were muslims of Hausa parents. Majority of patients’ mothers were between 19-35 years of age; 70% of the patients’ mothers were illiterates while most of the fathers were low income earners (56.7%). Only 36.7% of the mothers had antenatal care of which only 35.6% took folic acid medications. Over 90% of the mothers had persistent sources of heat exposure during pregnancy, majorly via cooking with firewood. Majority (72.9%) of the lesions were located in the lumbar and sacral regions. Wound infection was the commonest complication (50.0%). Only 45.6% of patients had hydrocephalus on TFUSS examination. Over forty two percent (42.2%) of the patients had excision plus VP shunt insertion. Mortality was higher with early presentation (13.3%) (P = 0.110). Wound infection was also commoner among those that presented early (26% superficial infection and 13.3% deep wound infection (P = 0.362). More patients who presented early had rupture with CSF leak (22.2%) with P = 0.03. Surgery reduces the incidence of local wound infection (P < 0.001). Surgery was also associated with reduction of incidence of failure to thrive with a statistical significance of P < 0.001. Conclusion Patients with myelomeningocoele present late in Sokoto and often with complications. Infection was seen to be the most frequent complication. Surgical intervention is associated with reduction of prevalence of failure to thrive and hydrocephalus in patients who presented early.