Urolithiasis is the first inpatient urological disease. The prevalence of urinary stones in China is 1% to 5%, and in the south it is as high as 5% to 10%, of which about 25% require hospitalization. China is one of the 3 major stone prevalence areas in the world, and its incidence has been on the rise in recent years. The causes of stone formation are complex and closely related to age, gender, genetics, environment, dietary habits, occupation, abnormal body metabolism, urinary tract obstruction, infection and other factors. Urinary stones can be found in the renal pelvis, ureter, bladder, urethra and other parts of the body, and stones in different parts of the body cause different clinical symptoms. Stones in the renal pelvis and ureter, which we call upper urinary tract stones, mainly cause lumbar discomfort, soreness and swelling, varying degrees of hematuria, and when stones are embedded in the renal pelvis or ureter, they can cause obstructive fluid retention or severe colic attacks. Lower urinary tract stones, i.e. bladder and urethral stones mainly manifest as frequent urination, painful urination, hematuria, and interruption of urine flow. The diagnosis of urinary system stones is well established in current diagnostic techniques. The diagnosis can be confirmed based on typical clinical manifestations and imaging examinations such as ultrasound, urogram, intravenous urography, CT or CT enhancement. Based on imaging examinations and necessary tests such as urine routine, it can help us to further understand the location, size, number and etiology of the stone and provide a clear reference for how to treat it next. The main complications of stones are causing obstruction and infection, because obstructive fluid accumulation causes renal function impairment and recurrent urinary tract infections, and prolonged stone stimulation can also induce squamous uroepithelial carcinoma, therefore, patients with urinary stones should take an aggressive treatment approach. Treatment of stones can be divided into conservative drug therapy, extracorporeal shock wave lithotripsy and surgical treatment. For stones with diameter <6mm, smooth surface without complete urinary tract obstruction and staying in the local area for <2 weeks, oral Chinese medicine can be considered first for stone removal, together with antispasmodic drugs and moderate exercise, which can effectively promote stone removal. For uric acid stones and cystine stones can be treated with oral potassium sodium bicarbonate or sodium bicarbonate tablets for lithotripsy? For stones for which drug treatment is ineffective or not suitable for drug treatment, lithotripsy and lithotripsy treatment should be actively undertaken surgically. With the development of extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotripsy (PCNL) and ureteroscopic lithotripsy (URL), most stones can now be treated in a minimally invasive manner. ESWL uses shock waves generated outside the body to focus on stones in the body to crush them, and urine is used to expel them from the body. The efficacy of lithotripsy is related to the size and location of the stone, the chemical composition of the stone, and the anatomical abnormalities of the urinary tract, with pelvic stones being easily crushed and middle and upper calyces having better efficacy than lower calyces. Patients with anatomical abnormalities, such as horseshoe kidney, ectopic kidney and other urinary tract abnormalities may also affect stone expulsion, which requires a combination of ureteroscopic or percutaneous nephrological procedures such as endoluminal surgery. For pregnant women, patients with urinary tract obstruction below the stone, severe obesity or skeletal deformity, urinary tract infection, or renal insufficiency are not suitable for eswl lithotripsy. Patients with obesity or skeletal deformity, urinary tract infection, and renal insufficiency are not suitable for eswl lithotripsy. Percutaneous nephrolithotomy requires the creation of a channel from the skin to the kidney at the waist to break up and remove the stones using laser and ultrasound. It is suitable for all kidney stones requiring developmental surgical intervention, including deerstalker stones, >50px kidney stones, stones in the diverticulum of the calyx, large stones in the upper ureter above L4, with heavy obstruction or length diameter >37.5px, or adjuvant treatment of stones that have failed ESWL or URL treatment. Compared with traditional modalities, PCNL is less invasive and can deal with multiple, large kidney and ureteral stones more efficiently with high stone removal rate. Contraindications are mainly uncorrected systemic bleeding disorders, severe cardiopulmonary insufficiency, and those who cannot tolerate the procedure. Ureteroscopic lithotripsy, including ordinary ureteral rigid mirror and new generation ureteral soft mirror lithotripsy, uses the natural lumen of human body-urinary tract for lithotripsy, combined with stone extraction forceps and lithotripsy mesh basket for stone extraction, its trauma is small and recovery is fast. For kidney stones with difficult ESWL localization (<50px), residual lower renal calyces stones after eswl, patients with extreme obesity, severe spinal deformity, and difficulty in establishing pcn channel, url lithotripsy can be adopted, and in combination with ureteral chondroscopy, intracavitary operation of calyceal neck stenosis incision can also be performed. With the application of new ureteral chondroscopy and high-power laser, ureteral chondroscopy can also be tried for kidney stones >50px in diameter where conditions permit, allowing patients to receive more minimally invasive treatment while ensuring stone removal rates. Major contraindications include patients with severe urinary tract infections, ureteral stenosis or difficulty in placement of the amputated stone due to systemic systemic disease. Patients who are obese, have severe spinal deformities, or have difficulty establishing pcn access may be treated with url lithotripsy, which in combination with ureteral chondroscopy also allows for intraluminal manipulation of the calyceal stenosis incision. With the application of new ureteral chondroscopy, high-power laser and other technologies, for diameters where conditions allow, other surgical modalities, such as laparoscopy or traditional open stone extraction, are now used significantly less in the treatment of urinary stones, mainly in diseases where surgical minimally invasive treatment has failed or where there is a need for simultaneous open surgical management, such as renal stones combined with pelvic ureteral junction stenosis. In conclusion, the treatment of urinary stones should be based on the individual differences and the specific situation of the patient, combined with the skill and experience of the operator, the instruments and equipment available, and the patient’s wishes, to adopt the best treatment plan.