Ureteropelvic junction obstruction (UPJO) in crossed renal ectopia with fusion is a rare condition. Management of UPJO occurring in ectopic kidneys generally requires open surgical reconstruction. Experience with minimally invasive techniques is minimal for repair of IJPJO in ectopic kidneys. We report what we believe to be the first documented case of laparoscopic ureteroureterostomy with the da Vinci robotic system in an adolescent with an obstructed upper pole system and crossed renal ectopia with fusion.