Purpose: To investigate the incidence and risk factors of urinary tract injury during total laparoscopic hysterectomy. Materials and Methods: All seven patients with urinary tract injury during past 14 years were reviewed retrospectively. The incidence of urinary tract injury and postoperative complications were studied. Results: There were two cases of bladder injury, three cases of ureteral injury, and two cases of vesicovaginal fistula. The urinary tract injuries were mainly diagnosed by indigo carmine dye, type-B ultrasonic, cystoscopy or intravenous pyelography. Two cases of bladder injury received bladder repair by laparoscopic or laparotomy successfully, three cases of ureteral injury were treated with internal ureteral stenting successfully, and two cases of vesicovaginal fistula accepted fistula repair by laparotomy three months after the initial total laparoscopic hysterectomy. Outcomes were all well in all cases. Conclusion: Early diagnosis and appropriate management of urinary tract injury is vital to allow prompt repair and limit postoperative morbidity.