Abstract Objective: To explore the clinical effects of upper ureteral calculi by using built-in 4F ureteral catheter with 200μm holmium yag laser fiber. Methods: We utilized the built-in 4F ureteral catheter with 200μm holmium yag laser fiber to perform lithotripsy on 46 upper ureteral calculi cases, in which the 4F ureteral catheter and 200μm holmium yag laser fiber were insert into ureteral catheter. Result: In this study, the lithotripsy rate was 95.66; the operation time was 36.5±4.8min; time of hospital stays were 2.9±0.4d; the duration of blood urine postoperative was 1.8±0.3d; the ureteral lumen pressure of pre-rubble, stone obstruction lifting, pro-rubble and finished lithotripsy were 25.6±1.2mmHg、51.6±4.3 mmHg、28.7±2.8 mmHg、12.4±3.5 mmHg, respectively. All patients were no ureteral injury, fever and bleeding. Conclusion: the treatment effect of built-in 4F ureteral catheter with 200μm holmium yag laser fiber on upper ureteral calculi was safe and reliable, affordable and easy to operate.