Ureteral injury is a known complication of gynecologic surgery with potential long-term sequelae. Traditional management of significant ureteral injury recognized at the time of transvaginal pelvic organ prolapse repair is a transabdominal re-implantation procedure using a transabdominal open or laparoscopic approach. We present a case describing a transvaginal approach for ureteroneocystostomy. During a transvaginal pelvic organ prolapse repair, a ureteral transection was noted. A transvaginal ureteroneocystostomy was performed. There was primary healing of the ureteroneocystostomy without sequelae during a 6-month follow-up period.