Ureteroarterial fistulas (UAF), a rare cause of hematuria [1,2] with a mortality rate reported as high as14-23% [2,3] were first reported in 1908 [4]. Although there has been an increase in incidence, reports in the literature consist only of case review and a single institution case series [2]. The identified predisposing factors for UAF formation are chronic ureteral catheterization, previous pelvic surgery, radiotherapy and vascular disease with previous vascular surgery or grafting [2]. Additional awareness of this complication may possibly aid in identification of high risk individuals and preventive measures. We present a review of UAF focusing on identifying patients at risk for fistula development, presentation, diagnostic imaging/procedures, and treatment modalities.