Uretero-colonic fistulae are a rare disease resulting from pathologic connection between the ureter and colon, which can be difficult to diagnose. This case report reviews the case of an 83-year-old female with a history of ovarian cancer treated with surgery, radiation, and chemotherapy, who developed a uretero-colonic fistula at a previous colon anastomosis site, which was later diagnosed by ureteroscopy. She was treated with stent placement followed by loop colostomy and was discovered to have metastatic ovarian cancer. She received palliative care consultation and was advised to follow up as an outpatient with the oncology and urology services. Although uretero-colonic fistulae are treatable, treatment depends on patients’ overall clinical picture.