Background: Herniation of transplant ureter into an incisional hernia is an uncommon and unreported cause of ureteric obstruction, which can lead to transplant dysfunction and diagnostic dilemmas. A report of our case and review of pertinent literature is presented.
Case Report: We report a 61-year-old lady, who presented with transplant dysfunction and hydronephrosis due to obstruction of the transplant ureter in an incisional hernia 8 years post-transplantation. An antegrade pyelogram and a computerised tomographic scan demonstrated an incisional hernia containing the obstructed transplant ureter. Antegrade stent insertion followed by an open mesh repair of the incision hernia restored normal alignment of the ureter and transplant renal function.
Conclusions: Due to its rarity, awareness of this condition is important in its prevention and successful management.

Keywords: Kidney Transplantation, incisional hernia, ureteric obstruction