A 42-year-old man presented with a horseshoe kidney with a nonfunctioning left moiety and bilateral ureteropelvic junction obstruction. Concomitant laparoscopic left nephrectomy and right pyeloplasty was performed. The total operative time was 5.7 hours, with a blood loss of <350 mL. There were no complications, and the hospital stay was 3 days. This appears to be the first such case reported.