IIdiopathic retroperitoneal fibrosis is an un-common disorder of unclear etiology characterized by a chronic and non-specific inflammatory process of the retroperitoneal fibro-fatty tissue. During the last decade, major advances have been made in the understanding and management of this entity and it is nowadays pro-posed to be the result of an autoimmune reaction that involves other surrounding structures, notably the ureters, leading the development of obstructive uropathy and secondary renal failure as the disease advances.To date, it has not been reported a widely accepted therapeutic schedule, although surgical approach has become the best treatment option in case of conservati-ve strategies failure. Surgical treatment main goals are obtaining biopsies of the fibrous plaque during the release of both ureters and their transposition inside the peritoneal cavity. This procedure is completed with a ureteral comwrapping with omentum to prevent a new entrapment. The purpose of this paper is the de-tailed description of the ureterolysis and omentoplasty technique, since, although recently some authors have reported small series of similar laparoscopic procedu-res, it is time consuming, complex and there is a possibility of potential serious complications, which still keep alive the con-ventional technique.