Abstract Background Ectopic prostate tissue is a rare clinical lesion that typically originates within the male urogenital tract. It is even more uncommon to find outside the urogenital tract or in female patients. The clinical symptoms of ectopic prostate tissue vary depending on the location of the disease. Case presentation We present the case of a 56-year-old Chinese male of Asian descent who presented with a space-occupying left ureter during a physical examination but did not exhibit any specific clinical symptoms. Preoperative urinary tract color ultrasound and pelvic magnetic resonance imaging examinations revealed nodular, abnormal signal shadows in the lower segment of the left ureter, necessitating further investigation into their nature. The initial preoperative diagnosis leaned towards a ureteral tumor owing to the uncertain nature of the lesion. During laparoscopic left ureteral exploration, rapid pathological sections indicated the presence of mature prostate gland tissue within the affected area. Subsequent laparoscopic left ureteral bladder replantation was performed, and postoperative pathology, along with immunohistochemistry results, confirmed the presence of ureteral ectopic prostate tissue. A comprehensive review of relevant literature, both domestic and foreign, was conducted to analyze the location of the ectopic prostate tissue, clinical characteristics, and various diagnosis and treatment options for this condition. Conclusion Ureteral ectopic prostate tissue is a rare disease that can be challenging to diagnose and treat accurately. Surgical removal of the affected tissue and subsequent histopathological examination are crucial steps to confirm the diagnosis. While the short-term prognosis for this condition is generally positive, long-term follow-up is necessary for optimal management.