Background: Sciatic hernias are the rarest form of pelvic floor hernias, predominantly occurring in women and containing either the bowel, bladder, ovaries, or ureters. There are currently fewer than 50 reported cases of ureterosciatic hernias (USH) in the literature. Given the rarity of this condition, there is no consensus about conservative versus operative management. There are currently six published reports of robotic-assisted laparoscopic USH repairs. Case presentation: A woman in her late 60s presented with right sided flank and groin pain which had caused intermittent symptoms over the past eight years, with no cause previously identified. A computed tomography intravenous pyelogram (CT IVP) showed a right sided USH with distal ureteric obstruction causing severe hydronephrosis. The patient underwent successful ureteric stenting with no obvious filling defects or intraluminal lesions identified. The following month, a robotic-assisted laparoscopic ureterolysis and repair of the right sided pelvic floor defect with a biodesign graft was performed. The ureteric stent was left in situ and the patient was successfully discharged the following day. Follow-up CT IVP five weeks post-operatively showed the right ureter had a normal course through the pelvis with no residual hydronephrosis, and the patient reported full resolution of her symptoms. Conclusion: Sciatic hernias are a rare condition to be aware of in patients presenting with persistent pelvic pain with no identifiable cause. This case presents a patient whose USH was complicated by obstructive uropathy. Ureteric stenting followed by planned robotic-assisted laparoscopic repair of the sciatic hernia successfully resulted in timely resolution of symptoms.