Ureteral trauma is relatively rare and besides penetrating or blunt trauma, most injuries are iatrogenic. Due to its mild symptoms, diagnosis of ureteral injury is often delayed. Later symptoms include flank pain, fever and uraemia or urinoma. Usually, the lower ureter is involved and computed tomography urography is the examination of choice when ureteral injury is suspected. Management of ureteral trauma depends on many factors like time of diagnosis, location, severity and aetiology of the injury. In general, an endourological approach with stenting or nephrostomy placement (method of choice in partial injuries or delayed diagnosis) and an immediate open or laparoscopic surgical repair can be distinguished. Surgical approaches include primary uretero-ureterostomy, ureteroneocystostomy (Psoas-Hitch or Boari Flap), ileal interposition graft and autotransplantation. Sometimes, nephrectomy could be necessary, but should be limited to severe cases, as preserving kidney function is the main goal. Recently, buccal mucosa grafts as ureteral stricture repair came to the field, but also robotic approaches were performed. More studies of huge trauma centers and longer follow-ups are necessary to gain more reliable data.