Objective To evaluate the feasibility and safety of laparoscopic ureteroureterostomy (LUU) in treating pediatric double kidneys with ureteral duplication.Methods Clinical data from 15 children diagnosed with double kidney with ureteral duplication who underwent LUU (LUU group) were analyzed and compared with data from 30 children with ureteropelvic junction obstruction (UPJO)-related hydronephrosis who underwent laparoscopic pyeloplasty (LP group). Parameters included preoperative/postoperative hydronephrosis severity (anteroposterior renal pelvis diameter, ureteral diameter), operative time, ureteral suturing time, intraoperative blood loss, postoperative complications, postoperative hospital stay, drainage volume and duration of abdominal drainage, and follow-up ultrasonographic regression of hydronephrosis. Perioperative outcomes were compared to assess LUU’s feasibility and safety.Results Operative time and postoperative hospital stay were longer in the LUU group than those in the LP group, the differences were statistically significant (P < 0.05); Postoperative ureterectasis significantly decreased in the LUU group, the difference was statistically significant (P < 0.05); The LP group exhibited faster overall regression of renal pelvis dilation than the LUU group, the difference was statistically significant (P < 0.05); The duration of postoperative indwelling urinary catheterization in the LUU group was longer than that in the LP group, with statistically significant differences (P < 0.05).Other parameters showed no statistically significant differences (P > 0.05).Conclusion Compared to LP (a common urethral reconstruction procedure), LUU requires longer operative time and hospitalization, with slower postoperative regression of hydronephrosis and a longer indwelling catheter time. However, other perioperative indicators and long-term complication rates were comparable. LUU is a safe and feasible emerging technique for reconstructing pediatric double kidneys and ureters.