Abstract: Objective: To investigate the efficacy and safety of ureteroscopic holmium laser lithotripsy in treatment of middle or lower ureteral calculi.Methods: Holmium laser lithotripsy was conducted in 70 cases of middle and lower ureteral calculi via rigid ureteroscope.There were 26 cases with middle ureteral calculi and 44 cases with lower ureteral calculi.Acute renal colic was occurred in 8 cases.Polyp was found in 22 cases and ureteral stenosis was found in 5 cases.Results: The successful lithotripsy in a single procedure was achieved in 67 cases and the success rate was 95.7%.Failure of ureteroscopy placement occurred in one case because of stricture of ureteral orifice.Calculi was translocated to renal pelvis in one case.Conversion to open surgery was occurred in one case because of polyp package of ureteral calculi.Ureteral perforation was occurred in 4 cases and urinary tract infection was occurred in one case who was recovered after use of antibiotics.There was no ureteral stenosis or calculous remnant happening after following-up of 2 to 6 months.Conclusions: Treatment of ureteral calculi by ureteroscopic holmium laser lithotripsy is an effective,less invasive and safe method.It should be the preferred way to patients with lower or middle ureteral calculus.