Abstract: Objective: To evaluate the clinical value of retroperitoneal laparoscopic ureterolithotomy for the treatment of impacted upper ureteral calculi. Methods: The clinical data of 21 cases by retroperitoneal laparoscopic ureterolithotomy (retroperitoneal laparoscopic group) and 27 cases by open ureterolithotomy (open surgical group) for the treatment of impacted upper ureteral calculi were retrospectively analyzed and compared. Results: All the 48 cases were treated successfully with no serious complication. Compared with open surgical group,intraoperative blood loss,the time of intestinal functional recovery,out-of-bed action and hospital stay after operation were significantly better than those in retroperitoneal laparoscopic group (P < 0.01), the time of operation, the time of drainage-tube and urinary catheter removed after operation had no significant difference between these two groups (P > 0.05). Conclusions: Retroperitoneal laparoscopic ureterolithotomy is safe, minimally invasive and effective. It may be the first choice for treatment of impacted upper ureteral calculi.