Background: The operative technique of laparoscopic ureterocalicostomy for significant ureteropelvic junction fibrosis associated with previous stone disease treatment is reported. Patients and Methods: Three female patients (mean age 32 years, range 25-38 years) presented with complications of urolithiasis treatment between 2003 and 2005. Significant pyeloureteral fibrosis was verified in all patients. A laparoscopic ureterocalicostomy to manage such defects was performed. Follow-up included clinical evaluation, nuclear renography, intravenous urography and serum chemistry. Results: The procedure was transperitoneally performed with a 4-port technique. Vascular control of the renal hilum was indicated in 2 cases (cases 1 and 3) with a mean warm ischemia time of 29 min (range 25-32 min). Mean operative time was 150 min (range 90-210 min) and mean blood loss was 550 ml (range 100-1,000 ml). Operations were performed in the left renal unit in all cases. Post-operative pyelograms verified adequate renal unit excretion. No significant variations on pre- and post-operative serum chemistry were verified. At a mean follow-up period of 26 months (range 12-32 months), there was no evidence of renal function loss which was demonstrated by nuclear renography. Conclusion: In experienced hands a difficult procedure such as ureterocalicostomy can be performed by laparoscopy. This is a complex procedure that is indicated in selected cases where the stenosis of the pyeloureteral junction is associated with an intra-renal pelvis. In our experience results are comparable with those previously reported in open surgery.