Ureteral trauma is uncommon and causes important complications. The clinical importance is supported by its high morbidity and mortality, and difficulties for obtaining a prompt diagnosis, due to in 95-100% of cases it is accompanied by extra-genitourinary injuries. The American Association for the Surgery of Trauma (AAST) has emitted an organ-injury grading scale, which has been validated for determining the correct clinical pathway and outcome. Treatment options are going from simple techniques of conservative management to very complex surgical maneuvers as auto-transplantation. Morbidity of ureteral injuries is on the order of 29% and mortality is present in 6.9% of cases.