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Giant urinary bladder stone is defined as a stone with a weight higher than 100 g. It is rare in women, accounting for approximately 2%. Its occurrence in the urinary bladder does not exceed 5% of the whole of the urinary tract. In women, the occurrence of urinary bladder stone is often secondary to a predisposing factor including intravesical foreign body, neurogenic bladder, repeated urinary infections, a history of surgery treating stress urinary incontinence. Therefore, there are some patients with a bladder stones without any obvious cause, such as primary idiopathic stone. We here report the case of a 31-year old patient with giant urinary bladder stone affecting the superior part of the urinary tract causing acute renal failure. The patient initially underwent bilateral nephrostomies to drain the superior part of the urinary tract; then giant urinary bladder stone was removed by open cystolithotomy. Etiological assessment didn't show any obvious cause.