Purpose: To understand the viability, safety and efficacy of the K-wire technique for externalised nephrostent placement in laparoscopic pyeloplasty. The technique has been previously described by the senior author in 2018.Methods: Retrospective analysis of consecutive laparoscopic pyeloplasties between June 2016 and November 2019 employing this technique. Pre-operative ultrasound (US) and MAG3 scans, procedure-related complications, hospital stay, further interventions and follow-up imaging were analysed. Stents are knotted in 48 h and removed on day 7 on return to the ward without the need for a second anaesthetic.Results: 38 patients had 38 pyeloplasties. Median age at surgery was 30.3 months (3.7–208.3 months), 28 were male and 20 patients had antenatal hydronephrosis. Pre-operative US median antero-posterior diameter (APD) was 28 mm (14–56 mm), median MAG3 was 42.5% (10–55%) of which 16 were under 40%. No procedure-related complications were noted. Median hospital stay was 2 days (2–4 days). In a couple, vesico-ureteric junction obstruction (VUJO) came to light needing a redo pyeloplasty with VUJO correction in one, and only a VUJO correction in the other. In one, stent removal was difficult as a suture had passed through it. Median follow-up was 19.4 months (range 7–38.3 months). Post-operative median APD on ultrasound was 8.5 mm (range 3–52 mm) and median MAG3 was 46% (range 12–53%).Conclusion: The study shows that the K-wire technique is a viable option which is safe and effective to provide stenting in laparoscopic pyeloplasty without the need for a subsequent procedure.