Bladder diverticulum is rarely associated to hydroureteronephrosis. We present clinical images of an adult patient with a bladder diverticulum near the ureterovesical junction (UVJ) with secondary obstruction. An 84-year-old man presented with left hydroureteronephrosis and a presumed 25-mm left ureteral stone at UVJ on computed tomography. Cystoscopy revealed a stone located in a bladder diverticulum just cephalad and medial to left ureteral orifice; the patient successfully underwent endoscopic laser cystolithotripsy with resolution of his hydronephrosis. Juxta-UVJ bladder diverticula may cause obstruction of the ipsilateral upper urinary tract.