Ureteral injury is one of the most serious complications of gynecologic surgery. Ureteral injury during laparoscopic surgery has become more common as a result of the increased number of laparoscopic hysterectomies and retroperitoneal procedures that are being performed. Consequently, prevention of ureteral injuries should be a priority during laparoscopic gynecologic surgery. When a ureteral injury does occur, quick recognition of the problem and a working knowledge of its location and treatment are essential in providing patients with optimal medical care. Detailed anatomic knowledge of the retroperitoneum is necessary to prevent ureteral injuries.