Access sheath-aided percutaneous antegrade ureteroscopy should be considered when access to the ureter is difficult. It allows entry/re-entry of the ureter with ease and requires no need for traditional dilatation and thus exposes the patient to minimal renal trauma. It can be used for the treatment of calculi, strictures and ureteric tumours. It provides particular benefit in patients with urinary diversion/reconstruction. In our small patient population it has shown to be a safe procedure with successful outcomes and minimal to no complications.