Background: Developmental abnormalities of the upper urinary tract including duplex system, ectopic ureter and ureterocele are frequently observed. Clinical presentations are variable and continue to challenge clinical management. Case Report: We are presenting a case of bilateral orthotopic; simple, ureterocele in an adult male with no congenital malformations of the renal or collecting system. The patient was diagnosed provisionally with bilateral ureterocele using abdominal ultrasonography in primary health care facility and referred to our urology clinic for further assessment and management. Conclusion: Bilateral intravesical ureterocele in an adult male with normal upper tract development is a rare clinical presentation. While, intervention is necessary in infants and young children, non-operative approach can achieve stable clinical scenario, maintaining both normal renal function and optimal quality of life in adults.