Ureterovesical junction (UVJ) obstruction refers to a blockage to this area causing hindrance to flow of urine down to the bladder, leading to urine back up into and causing dilatation of the ureters and kidney (megaureter and hydronephrosis). This is a 5-year-old male child referred for abdominal, pelvic and scrotal ultrasonography on account of moderate to severe supra-pubic pain radiating to the left loin and scrotal region with associated vomiting, sweating, occasional hematuria, increased urinary frequency and urinary tract infection for almost a year duration. The abdominal and pelvic ultrasonogram showed an oval echogenic area with posterior acoustic shadow measuring about 10mm in mediolateral dimension impacted at the left UVJ with associated dilatation of the left ureter, left calyceal moieties and pelvis. There is associated enlargement of left kidney with a bipolar length of about 144mm. A diagnosis of an obstructed left UVJ by an impacted calculus with associated hydronephrosis was established. The patient had a successful cystoscopy with pneumatic lithotripsy for surgical removal of the calculus, he got better and discharged home afterwards. We present a case of UVJ obstruction in a 5-year-old child due to its peculiar presentation, and to review the ultrasonographic findings