This is a case report of a ureteral obstruction from inguinal hernia entrapment with an ipsilateral cryptorchid testis in a 45-year-old male with an ectopic pelvic kidney. Ureteral herniation is unusual and to our knowledge has not been described in the setting of a patient with an ectopic pelvic kidney and undescended testis. The patient initially presented at an outside hospital with mild right lower quadrant abdominal pain and scrotal fullness, and initial computed tomography (CT) imaging demonstrated a pelvic right kidney with an indirect right inguinal hernia containing an entrapped ureter resulting in severe hydronephrosis. The CT also revealed an undescended testis on the patient’s right side. A nephrostomy tube was then placed in the right kidney under interventional radiological (IR) guidance and subsequent CT urography showed resolution of hydronephrosis. Surgical hernia repair was followed up on a later date. The discussion addresses the unique pathological features of this case while highlighting the relevant complications of a ureteral herniation.TopicsPelvic kidney, renal ectopia, ureteral obstruction, cryptorchidism, undescended testis.