Bladder stones constitute 5% of all urinary tract stones. Although small stones can be treated with transurethral cystolithotripsy, treatment of a large stone with this method may be more traumatic for the urethra and requires longer operative time. Alternatively, percutaneous cystolithotripsy, open or laparoscopic cystolithotomy can be performed in order to shorten the operative time. In the laparoscopic cystolithotomy, the method of stone extraction predominantly determines the cosmetic results. Alternative extraction routes to skin incision may be used for bigger stones to obtain better cosmetic results. Herein, we report a case of laparoscopic cystolithotomy with transvaginal extraction of a big bladder stone in a young woman and we discuss the related literature.