Objective To explore the diagnosis and treatment of ureterovaginal fistula caused by intrauterine device (IUD) ectopia, so as to provide reference for the diagnosis and management of this condition. Methods A retrospective analysis was conducted on the symptoms, signs, examination results, and treatment of a patient with ureterovaginal fistula due to IUD ectopia. The relevant literature was reviewed.Results The 41-year-old female presented with vaginal urinary leakage for more than 1 month. After admission, preoperative preparations were completed, and ureterovaginal fistula was confirmed with computed tomography (CT) and intravenous pyelography (IVP). After laparotomy was performed to remove the IUD, the patient was discharged after good recovery. Half a year after surgery, a telephone follow-up showed the patient had no subjective discomfort. Analysis of 5 reported cases of urinary leakage caused by IUD ectopia revealed that the main cause was long-term chronic inflammatory stimulation by the IUD. Among them, 3 cases were cured with surgical removal of the IUD and fistula resection; of the other 2 cases, 1 refused surgical treatment and 1 underwent transvaginal fistula repair. Conclusion Ureterovaginal fistula caused by IUD ectopia is a rare complication. Early diagnosis requires familiarity with its etiology and combination of examinations such as ultrasound, IVP, and CT. Early diagnosis and treatment can prevent severe complications.