Extracorporeal shock wave lithotripsy is clinically indicated mainly for stones in the upper and middle ureter. Because stones in the lower ureter, which are obscured by the abdominal bowel, can interfere with ultrasound-guided extracorporeal shock wave lithotripsy, which usually cannot completely crush the stones. Therefore, when a lower ureteral stone is diagnosed, the patient can choose the appropriate treatment after determining the size of the stone by X-ray or CT examination. In the case of lower ureteral stones, it is usually possible for them to pass on their own with conservative treatment. However, if the stone has been in situ for more than 2 weeks and has not moved, and if complications of hydronephrosis or urinary tract infection have arisen, aggressive lithotripsy should be performed after adequate anti-inflammatory and symptomatic treatment, usually by ureteroscopic holmium laser lithotripsy, so that the stone can be successfully discharged.