Background <p>Ureteral double-J (DJ) stenting is frequently performed in various urologic surgeries to treat ureteral obstructions or fistulas. Yet, it may result in early and late complications. We review a rare case of migration of the DJ stent into the cardiovascular system in female post-surgical exploration for repair of iatrogenic ureteric fistula. These cases, despite their rareness, underscore some serious complications of ureteral stents which have been used extensively in the urology era.</p> Case presentation <p>A 38-year-old female was admitted to the emergency department complaining of dyspnea and chest pain for 2&#xa0;months duration. She had intrapartum hemorrhage followed by supravaginal hysterectomy. A few days later, she started to complain of urinary leakage followed by CT imaging with IV contrast which confirmed a ureterovaginal fistula on the left side. Six months later, she underwent surgical exploration for the excision of the fistula, left ureterovesical reimplantation, and left DJ insertion. A follow-up imaging revealed an obstructed left kidney and intracardiac migration of the left DJ stent. A left percutaneous nephrostomy was done. Successful DJ extraction was carried out through an endovascular procedure without any negative outcomes.</p> Conclusion <p>Cardiovascular migration of ureteral stents is a very serious rare complication of urological procedures. The multidisciplinary team is vital for the best management of such cases. Early diagnosis of such complications and proper management are the keys to the best outcome.</p>