We report a case of spontaneous rupture of the ureter from an impacted calculus, paradigm of diagnostic and therapeutic difficulties of these uncommon pathologic conditions. Spontaneous rupture of the ureter from an impacted calculus should be considered in cases of persistent renal colic and atypical presentation. Diagnosis is based on urographic evidence of urinary extravasation. This should be differentiated from nephric colic from urinary extravasation arising from the renal fornices which is relatively common in nephric colic. Treatment must always include drainage of the urinoma, ureteroraphy, and urinary diversion. However, a controversy exists on the advantages and disadvantages of nephrostomy versus ureteral splinting.