Objective To present the long-term results of the interposition of ileum in the meter. Patients and methods An ileal loop was interposed to replace a long defect of the upper meter, with preservation of lower ureteric continuity, in nine patients (mean age 35 years, range 18-58). Patients were followed regularly for a mean of 5.2 years (range 2-7) and assessed using renal ultrasonography, isotopic renography and intravenous urography. Results Urinary drainage was satisfactory and renal function and configuration were improved. None of the patients experienced metabolic acidosis or electrolyte disturbances despite receiving no medication. Conclusion These results were encouraging and further clinical experience is needed to confirm that ileal interposition of the meter is a safe and effective procedure.