Ectopic ureter in a duplicated system in men is rare and rarely causes bilateral obstructive symptoms. The tendency of the ureter to dilate more than the caliceal system is unique to neonates and makes upper urinary diversions more challenging. However, alternative percutaneous diversions other than nephrostomy might be beared in mind in such cases with huge dilatation in ureters in suffering neonates. As discussed in this case percutaneous ureterostomy may be very effective and have a role in diagnosis and management of neonatal hydroureteronephrosis.