We report a case of a 32-year-old man, who presented to the emergency department with severe abdominal pain, with radiation to his back. An ultrasound examination revealed mild hydronephrosis bilaterally. A non-enhanced computer tomography was then performed and showed a 9 mm hyperdense image in the left ureter topography along together with an 8-mm hyperdense image in the right ureter topography, allowing us to establish the diagnosis of bilateral ureterolithiasis. The patient was taken to the operating room in order to perform ureteroscopy for endoscopic removal of the stones.