In the modern era of management of disorders of the upper urinary tract, ureteroscopy forms an important part in the armamentarium for the diagnosis and treatment of a variety of disorders that occur in the upper urinary tracts. The modern ureteroscopes have better vision and are less traumatic, making ureteroscopy a relatively safe procedure. Major complications are rare. An audit of a total of 128 ureteroscopies done in the Department of Urology over a six year period from August 2001 till August 2006 at the Sultan Qaboos Hospital, Salalah, was undertaken. The results are discussed in detail and compared with results from other centers. The management of a rare but dreaded major complication is discussed in detail.