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Herniation of the ureters into the inguinal canal is a rare but recognized phenomenon. It may be noted incidentally on cross-sectional imaging, or when it presents with complications such as obstruction or infection. It is important to highlight the finding when present, as surgical intervention will be required in the majority of cases. We present a case of a 91-year-old man who developed obstructive uropathy and pyelonephritis due to inguinal herniation of the ureter., (© 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)