Objective  To compare the efficacy of reusable flexible ureteroscopy (FURS) and disposable FURS in the treatment of renal lower pole calculi.Methods  The clinical data of 206 patients with lower calyx calculi treated in our hospital from January 2020 to March 2021 were retrospectively analyzed. The patients were divided into reusable FURS group (154 cases) and disposable FURS group (52 cases) according to different surgical methods.Differences of demographic characteristics, lithotripsy on the side, long diameter, number of calculi, stone hounsfield unit (HU), infundibulopelvic angle (IPA), operation time, complication rate, hospitalization time, stone free rate (SFR) and hospitalization expenses between  disposable FURS group and reusable FURS group were compared.Results  There were no significant differences in general condition, lithotripsy on the side, long diameter, number of calculi, HU, IPA, postoperative complications, hospital stay and stone clearance rate between the two groups (all P>0.05). The operation time of the reusable FURS group was higher than that of disposable FURS group [（42.96±16.81）min vs.(37.31±14.88)min, P=0.041]. The hospitalization cost of reusable FURS group was lower than that of disposable FURS group [（23 492.60±5 151.34）yuan vs. (29 262.33±2 099.96)yuan, P<0.001]. The number of calculi, the long diameter, HU and postoperative complications were correlated with the operation time (all P<0.05). Logistic regression analysis showed that the number of calculi, the long diameter and surgical methods were independent risk factors affecting the operation time (all P<0.05).Conclusions  For the treatment of renal lower pole calculi, the efficacy of disposable FURS is similar to that of reusable FURS. For patients with multiple stones and lager diameter, the disposable FURS may be preferred if economic conditions permit because it will bring a shorter operation time.