Ureteral injuries are an uncommon complication after gynecological procedures. The Authors consider separately direct lesions during surgery and those following radiotherapy. For both these situations preventive criteria, which permit a lower incidence in ureteral injuries, are considered. Early diagnosis and intraoperative repair are the most important tool for surgical lesions while the exact stage of neoplasm and N.E.D. status are fundamental for lesions resulting from radiation therapy. In our opinion, best treatment of stable lesions is surgery, while endourology is not usually a definitive treatment and has only a temporary and palliative role.