Ureteropelvic junction (UPJ) obstruction, in addition to causing progressive renal function loss, can lead to the formation of retained stones. Management planning for concomitant stones and UPJ obstruction is a topic of debate in the literature. We performed laparoscopic pyeloplasty and extracted all 144 stones from the renal pelvis and calyces of a 37-year-old male with UPJ stricture, using wireless flexible cystoscopic guidance. No complications occurred during the perioperative and postoperative periods. In challenging cases of UPJ obstruction with stones in multiple calyceal locations, simultaneous flexible cystoscopy offers clinicians a significant advantage.