Objective: To investigate the safety and effectiveness of ureteral chondroscopic holmium laser lithotripsy combined with retroperitoneal laparoscopic pyelotomy for the management of complex renal stones. Methods: From August 2012 to June 2013, a total of 16 patients with complete or partial deerstalker kidney stones and 2 patients with a history of open stone extraction were included in this group, including 9 males and 7 females, aged 7-82 years (mean 36.3 years). The bladder was first placed in the cystotomy position, and the ureter was first examined by rigid ureteroscopy, and then a soft ureteroscope sheath was placed. The ureter and renal pelvis were separated and then the renal pelvis was dissected by elevating the lumbar bridge and inserting a varicocele. At the same time, a ureteroscope is placed through the ureteral flexible sheath, and a holmium laser lithotripsy is performed to cut the stone into chunks and take it to the retroperitoneal space through the renal pelvic incision. Small stones are removed directly to the retroperitoneal space with a lithotripsy basket, while larger stones are removed with holmium laser cutting. All stones were then removed laparoscopically. A double J tube was placed in the ureter, the catheter was retained, and the renal pelvic incision was closed. The double-J tube was removed after 2-3 weeks. Results: All 16 patients were successfully completed, 15 cases (93.8%) had complete stone removal, and one case had one residual renal calyx diverticulum stone. Conclusion: Holmium laser lithotripsy with ureteroscopy combined with retroperitoneal laparoscopic pyelotomy for complex renal calculi is safe and feasible. Ureteral chondroscopic lithotripsy and laparoscopic laparotomy for stone extraction are both routine procedures with low technical requirements. With a pelvic incision, the pressure in the renal pelvis during ureteral soft lithotripsy for stone extraction is very low, which greatly reduces the risk of infection. Larger stones can be removed through the renal pelvic incision, which speeds up stone extraction and improves stone removal rate. Keywords:Ureteral flexible scopy, laparoscopy, pyelotomy for stone extraction, kidney stones.