Conventional simultaneous bilateral open nephroureterectomy combined with resection of bladder cuffs seems not optimal for bilateral upper tract urothelial carcinoma (UTUC) in renal transplant and dialysis patients with enormous invasion related to large morbidity,delayed gastrointestinal function,and late recovery.1 This study reports the largest series of minimally invasive procedures of simultaneous bilateral retroperitoneoscopic nephroureterectomy (SBRNU) via a midline lower abdominal incision in renal recipients.