Aorto-iliac aneurysms may entrap the ureters in perianeurysmal fibrosis, causing medical ureteral deviation and/or obstruction. The latter has been described only in male patients; a further 5 cases due to iliac and 3 to aortic aneurysm are reported. The radiologic picture resembles retroperitoneal fibrosis; the correct diagnosis may be suggested when ureteral tethering or narrowing lies near arterial calcification. Sonography is usually the most appropriate investigation to confirm the diagnosis. When sonography shows an aortic aneurysm, the kidneys should be scanned to rule out hydronephrosis. Similarly, films of the kidneys should be obtained when an abdominal aneurysm is demonstrated by aortography.