The clinical necessities of replacing all or part of the diseased or destroyed ureter have plagued surgeons for many years. In the past seventy years more than 100 surgical techniques have been described for ureteral replacement. Methods of replacement have fallen into four categories; nonbiologic substitutes, pedicle grafts, free grafts, and implantation and diversion. This review discusses the history and present status, and presents a look to the future in the surgery of ureteral replacement.