Background <p>Double-J (DJ) stents are commonly used to ensure upper urinary tract drainage in patients with ureteral obstruction. While cranial or caudal migration of DJ stents is occasionally observed, extraluminal migration beyond the urinary tract is exceptionally rare. In this case, we report the first-ever published case report of a DJ stent migration into the liver parenchyma.</p> Case presentation <p>We report the case of a 42-year-old man with a history of right staghorn calculus and multiple urological interventions, including lithotripsy and repeated DJ stent placements. Despite adequate stent positioning on prior imaging, follow-up studies revealed proximal migration of the DJ stent into the inferior segment of the right hepatic lobe. Computed tomography (CT) confirmed the stent’s intraparenchymal hepatic position with minimal perihepatic fat stranding, suggesting a chronic process rather than acute perforation. Possible mechanisms include chronic inflammatory erosion, tissue fragility from repeated procedures, or gradual displacement due to peristaltic and respiratory motion.</p> Conclusions <p>This is the first reported case of a DJ stent migration into the liver parenchyma. Clinicians should maintain a high index of suspicion for stent malposition in patients with persistent symptoms and prolonged stent use, emphasizing proper insertion technique, stent sizing, and close radiologic monitoring.</p>