Swiss Ultrasonic Pneumatic Ballistic Lithotripsy System (EMS) is the fourth generation of advanced lithotripsy system in the world today, which is recognized as the “stone nemesis”. In January 2009, the Department of Urology of Shanghai Fifth People’s Hospital, affiliated to Fudan University, introduced the first fourth generation Swiss ultrasonic pneumatic ballistic lithotripsy system in southwest Shanghai at a huge cost. The ultrasonic pneumatic ballistic lithotripsy system combines the functions of ultrasonic lithotripsy, pneumatic ballistic lithotripsy and negative pressure suction into one, combining the best of multiple lithotripsy methods and optimizing the efficiency of stone removal to the greatest extent. For large stones or hard stones, the Holmium laser lithotripsy process can be quite slow and the procedure time can be long, but if the ultrasonic pneumatic ballistic lithotripsy system is used, the stones are first broken into large pieces by pneumatic ballistic lithotripsy, and then further crushed and removed by ultrasonic lithotripsy, the treatment time can be greatly reduced. For smaller or brittle stones, simple ultrasound lithotripsy can be used directly with good clinical results. Ultrasound combined with pneumatic ballistic lithotripsy, in addition to the safety and quick recovery features of minimally invasive surgery, is more efficient than other procedures in removing stones. In addition, its negative pressure suction function is unique in that most of the stones can be sucked out immediately while lithotripsy is performed. With the EMS system, the Holmium laser system and the combination of nephroscopy and ureteroscopy, our urology department has reached the city’s advanced level in minimally invasive surgery for urinary stones.