Multiple stones with hydronephrosis can be treated with extracorporeal shock wave lithotripsy, percutaneous nephrolithotripsy, ureteroscopic lithotripsy and lithotripsy, laparoscopic surgery and nephrostomy. Kidney stones, ureteral stones can cause hydronephrosis, the severity of its condition and the time of urinary tract obstruction has a close relationship, should be relieved as soon as possible, the treatment program should be combined with the patient’s specific conditions. 1. Extracorporeal shock wave lithotripsy: it is mainly applied to kidney stones with a diameter of ≤2cm and upper ureteral stones. The effect of lithotripsy is related to the location, size, nature and whether the stone is embedded or not, and the effect of stones with a large volume and hard texture is poor. 2. Percutaneous nephrolithotripsy: basically, it is suitable for all kidney stones that need surgical intervention, including ≥2cm kidney stones, stones that are difficult to be crushed by extracorporeal shock wave and those that fail to be crushed by treatment, and staghorn stones. 3. Ureterorenoscopic lithotripsy: it is suitable for middle and lower ureteral stones, upper ureteral stones that have failed extracorporeal shock wave lithotripsy. 4. Laparoscopic ureterotomy and lithotripsy: suitable for ureteral stones >2cm, or stones that have failed the above treatments. 5. Nephrostomy: if the patient’s condition is critical and it is difficult to support larger surgery, percutaneous nephrolithotomy can be performed under ultrasound guidance to drain the urine, in order to help control the infection and improve the renal function; relevant treatments will be performed after the patient’s physical condition permits. Multiple stones with hydronephrosis should be selected under the guidance of specialized physicians for appropriate treatment.