Bilateral synchronous urothelial tumors in the upper urinary tract seem to be rare. To our knowledge, only 34 cases have been reported previously. A 77-year-old-man with the chief complaint of macrohematuria was admitted. Clinical investigations showed left ureteral and right renal pelvic tumors. Resection of the wall of the right renal pelvis and partial ureterectomy and its reanastomosis in the left ureter were done. Pathologic examination revealed that the right renal pelvic tumor was transitional cell carcinoma (G.2, pTlb), and the left ureteral tumor was invasive metaplastic epidermoid carcinoma. The patient is alive with no recurrence or metastasis 1 year after the operation. We reviewed all the reports of bilateral synchronous tumors we could find and discussed the histological findings and treatments reported.