A 70-year-old woman with an ileal conduit developed stones in both kidneys and the right ureter. A Double-J stent was placed to facilitate treatment of the stone on the right side. After nearly complete clearance on the right side, an attempt to retrieve the stent was unsuccessful because of a knot at the proximal end that was impacted at the ureteroilial anastomotic site. We describe removal of this impacted knotted stent with a conservative approach.