We report a case of retroperitoneal fibrosis. A 75-year-old man complained of edema of bilateral lower limbs and lumbago. Blood urea nitrogen and serum creatinine were increased. Renal function was improved after he had bilateral percutaneous nephrostomies. Antegrade pyelography showed bilateral hydronephrosis, left ureteral obstruction and medial deviation with narrowing of the right ureter. CT revealed a soft tissue density surrounding the aorta, inferior vena cava and bilateral ureters in the retroperitoneal space. Inferior venocavagraphy displayed stenosis. Bilateral ureterolysis combined with omental sleeve plasty was performed. Post-operatively, the clinical course has continued to be good.