OBJECTIVE We evaluated a new simplified technique for secondary surgical correction of persistent reflux in a reimplanted dilated ureter. METHODS Four patients a median of 3 years old with recurrent vesicoureteral reflux after initial reimplantation of ureters greater than 9 mm. in diameter underwent in situ excisional ureteral tailoring. RESULTS Followup ranged from 15 to 27 months (mean 22). Within 3 months postoperatively ultrasound confirmed no ureteral obstruction, and at 3 to 6 months voiding cystourethrography revealed no vesicoureteral reflux in any case. CONCLUSIONS Our study highlights the surgical details and safety of this technique for preserving the vascularity of the reconstructed ureter and avoiding injury to the contralateral ureter.