A review of 54 consecutive cases of ectopic ureterocele treated at our institution in the last 15 years revealed 4 cases of the cecoureterocele variant. Although the diagnosis of ectopic ureterocele was made preoperatively, the more accurate diagnosis of cecoureterocele was not suggested by preoperative radiographic studies. The cecocele component was disclosed only at endoscopy or during open resection of the ureterocele. A review of the presentation, preoperative assessment, intraoperative management and outcome of each case of unsuspected cecoureterocele suggests that optimal surgical management of the cecocele itself does not require total removal.