Urolithiasis is a generic term for stones in the urinary organs. Some ureteral and bladder stones originate from the kidney, so timely treatment of kidney stones is especially important. Urolithiasis is not only an ancient but also a common condition in modern urology. The application of modern imaging technologies ultrasound, X-ray and CT has significantly increased the detection rate of stones and led clinical medicine to develop new treatment methods. Currently, there are many treatment modalities for urolithiasis, drug lithotripsy, surgical stone extraction; extracorporeal lithotripsy, internal lithotripsy, stone extraction; traditional open surgery and modern minimally invasive surgery. It is the responsibility of the urologist to choose the appropriate and reasonable treatment for different individuals with the characteristics of kidney stones, and to manifest the principle of scientific treatment. It is a medical principle that extracorporeal shock wave lithotripsy is preferred for kidney stones of 5-20 mm, but it is not suitable for stones in the infrarenal calyces, diverticula or stones with obstruction of the drainage tract, due to the location and local structure of the stone. In addition, excessive obesity, diabetes, hypertension and coagulation disorders are also not indications. It is evident that the choice of extracorporeal lithotripsy for kidney stones should also be considered twice, otherwise it increases the damage and does not bring benefits. For kidney stones smaller than 5mm, the natural elimination rate is more than 90%, therefore, although the stones will grow in the body, they do not always need to be removed immediately. For those who do not have symptoms, ultrasound examination once every six months and change of bad dietary habits can be done without special treatment, and it is important not to take large amounts of Chinese medicine for a long time. The irreversible nephrotoxicity of some Chinese medicines has been confirmed in uremic patients. For those who have symptoms, symptomatic treatment such as pain relief and antispasmodic treatment can also be combined with extracorporeal shock wave lithotripsy at the same time. This small stone must be differentiated from tubular wall and tissue calcification in the renal collecting zone to prevent misdiagnosis more than treatment. For kidney stones larger than 20 mm and other complex stones, direct percutaneous nephrolithoscopy with holmium laser, vapor compression ballistics or ultrasound lithotripsy and stone extraction is the medical principle of choice. Each of these lithotripsy modalities has its own advantages, and the choice is based on the physician’s habits and hospital conditions. For stones with structural abnormalities of the kidney, percutaneous nephrolithotripsy can be used to correct abnormal structures such as calvarial stenosis and diverticula, which are the root causes of stone formation, and to treat benign lesions such as polyps and tumors at the same time. For stones that are ineffective with conservative treatment, multiple and cannot be broken by extracorporeal shock waves, percutaneous nephrolithoscopy has replaced the traditional open stone extraction. The size of the stone is the main factor in determining the treatment modality. The nature, structure and location of the stone, its environment and renal function are also key factors in determining the success of treatment. For example, cystine stones are the hardest and not easy to break, while magnesium ammonium phosphate stones are the loosest and easy to break; crystalline structures are easy to break and oolitic structures are difficult to break; stones surrounded by water are easy to break and those encapsulated by tissue are difficult to break; stones in the infrarenal calyces require inversion assistance, and normal kidney function is a guarantee for expelling stone fragments. In short, for each body and each stone, comprehensive analysis is carried out so as not to over-treat, not to mis-treat; to remove stones without damaging the organism; to be able to minimally invade, not to operate; to treat with the principle of minimum cost, minimum pain, safe and complete removal.