Bladder stones are not a rare disease, but it is rare for such a calculus to be so large as to cause bilateral hydronephrosis. In a previous report, we described an unusual case of spontaneous bladder rupture due to a giant bladder stone. The patient was a 68-year-old man, who had undergone primary repair of bladder rupture and cystolithotripsy of a giant bladder stone with lithoclast at the age of 63 years old. Then he did loss follow-up to the hospital for 5 years. After 5 years, he came back to the hospital with the same symptoms such as decreased urine volume, suprapubic discomfort. Fortunately, the previous treatment which consisted of litholopaxy and antibiotics was effective again. Worldwide, it is the first reported case of recurrent acute renal failure and urinary tract infection after bladder spontaneous rupture due to a giant bladder stone. (Korean J UTII 2012;7:178-181)