The epidemiology of peptic ulcer disease (PUD) has changed considerably in the last several decades. Previously a chronic disease characterized by frequent recurrences with a high rate of surgical interventions, it is now largely a self-limited disease that is medically managed. The role of acid suppression was widely recognized as being important in the pathogenesis of PUD in the 19th century, while it was not until the 1980s and 1990s that the importance of Helicobacter pylori infection was identified. Today, PUD is largely caused by either H. pylori infection or nonsteroidal anti-inflammatory drug use. However, other less common etiologies of this disease are becoming more relevant as the prevalence of H. pylori decreases and proton pump inhibitor therapy is increasingly common. Here, we report a case of duodenal ulceration following bilateral rigid ureteroscopy with holmium laser lithotripsy.