Retroperitoneal fibrosis sometimes causes urological problem involving the ureter, but the mechanism is uncertain. The most common treatment of retroperitoneal fibrosis is often a surgical exploration followed by urologic intervention, but medical therapy has been advocated recently. For medical therapy, there is necessary to exclude malignancy and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) scan may be an useful alternative tool to avoid invasive procedure including open biopsy. Here we report two patients who were undergone the FDG-PET scan to exclude malignancy and received successful treatment of retroperitoneal fibrosis with prednisolone.