What is the role of crossing vessel and how to treat it? Kim et al. suggest that a laparoscopic vascular hitch (VH) has a similar high success and low complication rate as dismembered pyeloplasty in paediatric PUJ obstruction with crossing vessel (CV) and excluding intrinsic obstruction. The VH for well-selected cases was correlated with shorter operative time and hospital stay, lower use of stents and postoperative pain. Nevertheless, there are some concerns about the role of the CV in the aetiology of PUJO, the importance of CV management in prognostic outcomes, and the intraoperative criteria for well-selected patients for VH.