Laparoscopic pyeloplasty is an effective treatment option for ureteropelvic junction obstruction, with success rates superior to other minimally invasive approaches. We describe our technique of laparoscopic pyeloplasty with antegrade placement of ureteral stent with a laparoscopic-guided abdominal puncture. This technique decreases the use of fluoroscopy and also facilitates renal pelvis dissection and ureteropelvic anastomosis.