UroLume stents have been used for >15 years to improve the voiding dynamics in patients with benign prostatic hyperplasia and urethral stricture disease. Common complications include stent migration, stricture within the stent, and urothelial hyperplasia, any of which could require stent removal, which itself carries morbidity. We report a case of high-grade urothelial carcinoma associated with chronic UroLume application.