Abstract Background Horseshoe kidney (HSK) is a common renal fusion anomaly, occurring in about 1 in 400–600 individuals. In addition, the incidence of duplicated collecting system is about 0.8%. Case presentation This report documents an extremely rare case, which was treated by multiple procedures in the same operative session to accomplish laparoscopic amputation of the HSK isthmus, resection of duplicate kidney and ureteroscopic lithotripsy. Conclusion Results showed that minimally invasive surgery with use of multiple endoscopes may be a feasible choice for this patient population with complicated comorbid renal conditions.
