First of all, we should understand that the term anuria does not mean not urinating for a short period of time or not being able to urinate, but rather a urine output of less than 100 ml in 24 hours a day. Anuria is a very serious complication of urolithiasis, and patients often have different degrees of azotemia and water and electrolyte imbalance. If left untreated, the condition will gradually worsen, and even acute renal failure will occur, endangering the patient’s life. Therefore, when patients with urolithiasis find that the 24-hour urine output is significantly reduced, they should go to the hospital immediately and not delay treatment. For urolithiasis patients with acute anuria, the cause of the anuria must first be clarified. Urolithiasis patients with anuria are mainly due to: ① bilateral ureteral obstruction at the same time; ② sole kidney (congenital sole kidney or the opposite side of the kidney due to disease was surgically removed) due to the ureteral stone caused by complete obstruction; ③ one side of the kidney is no longer functioning, the other side of the kidney occurs in the ureteral obstruction. Anuria can occur suddenly or on the basis of a gradual decrease in urine output. When it is considered that the anuria may be related to ureteral obstruction caused by stones, doctors often need to take a KUB and ultrasound to clarify the location of the stones and the degree of hydronephrosis. If the stone cannot be detected by KUB and ultrasound, a CT scan will be done immediately to confirm the diagnosis. After the diagnosis is confirmed, the doctor will usually insert retrograde ureteral catheters into one or both ureters to drain the urine. If the catheterization fails, an ultrasound-guided percutaneous nephrostomy is needed to drain the urine, and at the same time, extracorporeal shock wave lithotripsy or surgical treatment is given in an emergency. Surgical treatment can be divided into transureteroscopic drinking laser lithotripsy, pneumatic ballistic lithotripsy, ureterotomy lithotripsy and so on. In short, as long as the treatment is timely, remove the stone and relieve the obstruction, the renal function may be restored to a certain extent, otherwise, the missed opportunity will bring irreparable consequences to the patients.