Introduction: Obstruction of the lower ureter by pelvic cancer requires palliative treatment. Percutaneous derivation is often performed in an emergency context. If the obstruction is limited to the perimeatic area; the percutaneous antegrade recanalization can be performed and may require a resection of the ureteral orifice. Objectives: We evaluate the results of percutaneous antegrade recanalization associated with possible bladder resection in the treatment of pelvic neoplastic ureteral stenosis. Materials and Methods: A retrospective, descriptive study from September 2016 to January 2021 included all patients with complicated pelvic tumor with ureteric hydronéphrosis. Under general anesthesia, in Valdivia modified position, a nitinol hydrophilic guidewire is passed through the nephrostomy and retrieved from the bladder to the urethral meatus, followed by a descent of ureteral catheter under X-ray control. We might need a resection over the presumed ureteric meatus as it will help open the lower extremity of the ureter, so it can be easily catheterized with a double J. When needed, the resection is performed in the modified Valdivia position, it requires significant vigilance and the resection is controlled by fluoroscopy by visualizing the proximity of the resector and the guidewire in the ureter. Results: In our study, 74 patients, including 29 men and 45 women, with an average age of 65 years (52–78 years). The Karnofsky index was ≥≥80% 80% in 92% and between 80% and 60% in 8% of patients. The average extent of ureteral stenosis was 2.25 cm (1–3.5 cm). The etiologies of obstruction were dominated by cervix cancer at 58.2%, followed by prostate cancer at 33.7% and bladder cancer at 8.1%. The recanalization is carried out in 40% on the left, 60% on the right, and bilaterality in 30% of the cases. In the event of bilateral obstruction, the repermeabilization was carried out in two deferred stages, one side at a time, the priority kidney being the one which seemed more functional with a good corticomedullary index. The improvement of renal function in 82%, however, 18% progressed to chronicity. The disappearance of the dilatation was present in 85%, whereas 15% of the cases presented a residual dilation without alteration of the renal function. The resection of the ureteral meatus was performed in 75% of the cases. We had only one recanalization failure in our series because the stenosis was extensive, due to the intrinsic invasion of the ureter by the tumor. A few complications were noted: pyelonephritis (7%), isolated flank pain (10%), and bladder irritative syndrome (13%). The average survival of these patients depended essentially on pelvic cancer responsible for the obstruction, ranging from 11 months to 45 months. Conclusion: Percutaneous recanalization associated with bladder resection is an attractive, reproducible, and well-tolerated technique. Very few complications are reported. It provides a good quality of life to patients.