Nephrostomy tubes occasionally are resistant to extraction. During the last 7 years 3 such patients with entrapped Malecot nephrostomy tubes have been treated successfully at our university. The entrapped nephrostomy tubes were removed by endoscopically incising an anchoring tissue bridge that had grown over a flange. A small endoscope was easily advanced through the lumen of the entrapped catheter to allow for adequate visualization and electrocautery of the anchoring tissue bridge. With this method an entrapped Malecot nephrostomy tube may be removed intact without significant injury to the renal parenchyma. Malecot nephrostomy tubes should be used with caution for long-term drainage of small intrarenal pelves.