Prenatal hydronephrosis (HN) is a prevalent issue in pediatric urology, yet predicting the need for surgical intervention often demands frequent ultrasounds and invasive tests. Researchers have developed a deep learning model that uses kidney ultrasound images to determine whether HN is due to an obstruction requiring surgery. This model demonstrated high accuracy with an AUC of 0.93 and an AUPRC of 0.75, and has the potential to reduce unnecessary testing by accurately identifying patients in need of surgical intervention, thereby enhancing clinical efficiency and consistency.