Ureteral stone is a common disease in urology. Ureteroscopic pneumatic ballistic lithotripsy is a new urological intracavitary lithotripsy technique that was applied to the clinic in the early 1990s. The principle of lithotripsy is to use compressed gas to push the bullet body in the handle of lithotriptic machine to impact the lithotriptic probe to break the stone with rapid movement. The probe impact amplitude is small, does not produce heat energy, and the damage to the mucosa is slight and short-lived. However, upper ureteral stones cannot be used as the preferred method of ureteroscopic pneumatic ballistic lithotripsy. I. Indications for ureteral pneumatic ballistic lithotripsy: (1) The lower and middle ureteral stones are large in size. (2) Poor renal function of the affected side, poor efficacy of ESWL or the need for a long course of treatment. (3) The lower ureteral stone is small but difficult to expel and difficult to localize by ESWL. The embedded stone with a long residence time and ESWL is difficult. (4)Combined application with ESWL, for the lower and middle ureteral stone, the volume is large, due to the limited energy of pneumatic ballistic lithotripsy, such as preoperative localization is convenient, can be preceded by ESWL, will be part of the stone broken, so that the effect of pneumatic lithotripsy is more effective in the operation, and part of the pneumatic ballistic lithotripsy of the stone fragments such as the residual larger discharging difficulties, can be combined with the application of ESWL to improve the cure rate. (5) Treatment of “stone street” after ESWL. (6) Stones complicated with suspected urinary tract stenosis, polyps, obstruction, parcels, epithelial tumors need to be clearly diagnosed. (7) X-ray negative ureteral stones. Ureteroscope inserted into the ureter is the key to the success of lithotripsy. For beginners, it is easy to insert the ureteroscope into the bladder, but it is difficult to insert it into the ureter, we usually insert the ureteroscope into the ureteral catheter or the zebra catheter, and then enter into the ureter as a guide, and then we take the methods of lowering pressure, rotating, and picking up the ureteroscope, and then we push the ureteroscope upwards, and then we combine the saline infusion to dilate the ureter, and then the ureter will be expanded. If the ureter is dilated by saline infusion, it is easy to enter the ureter, pay attention to the field of vision when entering the mirror, if the field of vision is not clear, do not blindly push up the mirror, which may easily lead to perforation or even fracture of the ureter. Third, lithotripsy needs to pay attention to a few points: for ureteral inflammatory stones or stones around the inflammatory polyps, if you can find the stone, before lithotripsy, do not prematurely clamp the polyp, so as not to bleed, affecting the field of view of the inconvenient operation. If the surface of the stone is smooth and easy to move, the lithotripter can be pressed gently to keep the stone close to the ureteral wall, or the stone can be set in a net basket to make it not easy to move and to facilitate the crushing of the stone. For larger stones 1,5cm, ESWL can be used to break the surface of the stone before operation, so that it is easy to crush the stone during operation. Fourth, on the double J-tube or ureteral catheter retention problem: If the operation is smooth, ureteral mucosal damage is slight or no ureteral injury, then there is no need to place a ureteral catheter. If the injury is significant, a ureteral catheter should be placed. The catheter is retained for 1-3 months and removed as needed. In conclusion, among the various treatments for ureteral stones, the advantages of ureteroscopic lithotripsy are highlighted in: avoiding the pain of open surgery, quick recovery of the patient after surgery, shorter hospitalization, fewer complications, and fewer medications. url is an ideal method of treating ureteral stones, and although there are many reasons why it may be difficult to increase the difficulty of the procedure, as long as it is operated skillfully and with flexibility to grasp the indications, the combination of ESWL can improve the success rate of lithotripsy.