Orthotopic ureteroceles may present with various symptoms, such as bladder irritability, flank pain, stone formation or recurrent urinary infections. When symptomatic, excretory urography often demonstrates varying degrees of hydronephrosis. We herein review a series of 12 patients in whom endoscopic ureteroneocystostomy (distal incision of the ureterocele) was performed. The procedure, and its theoretical advantages and indications are discussed. The results indicate excellent therapeutic benefit from this minimally invasive technique.