Point-of-care ultrasound is often used as first line imaging for the evaluation of flank pain in the emergency department and can potentially expedite diagnosis or decrease the use of abdominal CT scans, preventing unnecessary radiation exposure. This is a case report of a 77-year-old female who presented with acute flank pain. Point-of-care ultrasound revealed the absence of a ureteral jet on the right side, supporting the diagnosis of ureteral obstruction, which was confirmed on computed tomography. This case report aims to demonstrate the value of identification of ureteral jets when using point-of-care ultrasound to diagnose ureteral obstruction. Knowledge of more subtle and specific ultrasound findings such as this can help expedite more precise diagnoses.TopicsUreteral obstruction, ureteral jets, hydronephrosis, renal colic, renal calculi, point-of-care ultrasound, flank pain.