Excretory urography has been the most important examination in retroperitoneal fibrosis (RPF). Medial deviation of the ureters at the level of the lower lumbar spine with hydronephrosis and dilatation of the upper part of the ureters have been considered diagnostic of RPF. Nowadays RPF can be easily recognized via CT studies, provided if appears as a mass. However, often CT studies do not detect PRF in spite of the presence of characteristic urographic changes and although RPF has been diagnosed microscopically. RPF involves the vascular system, too, and the visualization of compression or occlusion especially of the inferior vena cava or the iliac veins is also helpful in the diagnosis of RPF. In this paper we describe a case of RPF (diagnosis was confirmed histopathologically) with characteristic urographic changes, but no evidence of retroperitoneal mass. However, in this case RPF had led to a circumscribed phlebectasis of perivesical veins, which we demonstrated via CT and angiography.