Objective To explore the value of pneumatic lithotripsy under ureteroscope in the management of ureteral calculus . Methods The clinical data of 360 cases of ureteral stones treated ureteroscopically by pneumatic lithotripsy were retrospectively analyzed. Results Stones were successfully fragmented on one session in 85% of the cases (306/360). Complications were observed in 2 5% of the cases (9/360), including 6 cases of ureteral perforation and 3 cases of urinary infection. Conclusions Pneumatic lithotripsy under ureteroscope is safe, effective and minimally invasive.