A 22-year-old patient had a stone in the left part of the ureter, which was found to have all the radiologic characteristics of pelvic lipomatosis. These were the following: radiolucency of the pelvic area as shown on plain film; a high lying bladder shaped like a teardrop as seen on excretory urogram; and an elongated rectosigmoid colon as shown on barium enema examination. The calculus caused only mild dilatation of the upper urinary system, and the stones passed spontaneously. Hence, the patient did not require operation. A review of the literature reveals that most patients suffering from pelvic lipomatosis present with urinary symptoms. Since operative release of pressure is difficult and usually incomplete, it is fortunate that surgery is seldom necessary.