Uretero-Iliac artery fistula (UIAF) is a rare condition in vascular surgery, its prognosis remains poor with a high mortality, requires rapid multidisciplinary diagnosis and treatment. We report the case of an uretero-Iliac artery fistula in a 65-year-old patient who underwent total pelvectomy with trans-ileal cutaneous ureterostomy (Bricker), followed by pelvic radiotherapy, and placement of a single J ureteral stent, diagnosed by abdominal and pelvic CT, and treated by endovascular approach.