A two-and-half-year-old male neutered rabbit was referred for investigation of intermittent urinary disease of 13 months in duration. Case work-up led to the diagnosis of unilateral hydroureteronephrosis following obstructive ureterolithiasis. The establishment of contralateral kidney function before ureteronephrectomy constituted a particular diagnostic challenge. This was assessed by a combination of imaging, serum biochemistry, urine protein to creatinine ratio and γ-glutamyltransferase index. Ureteronephrectomy was subsequently performed, with initial remission of all clinical signs. However, an adhesion of mesenteric adipose tissue to the caecum was identified and resected following frequent re-presentation. At the time of submission (800 days following initial surgery), the rabbit was still alive and healthy. The successful outcome may indicate a more favourable prognosis for rabbits with unilateral ureteronephrolithiasis and/or hydroureteronephrosis than is historically proposed.