Objective To develop and validate a nomogram for predicting residual calculi after ureteroscopic holmium laser lithotripsy(URHL)in patients with ureteral calculi in Xinjiang. Methods A total of 445 patients undergoing URHL in our hospital were enrolled and randomly divided into a training cohort(n=356)and a validation cohort(n=89)in an 8:2 ratio. The training cohort included 46 patients with stone residual and 310 patients with stone clearance. Factors influencing stone residual after URHL were screened with logistic regression analysis, and a nomogram prediction model was constructed based on these factors. The predictive performance of the model was evaluated using the training and validation sets data through receiver operating characteristic(ROC)curves and calibration curves. Results Multivariate logistic regression analysis revealed that daily water intake, number of stones, maximum stone diameter, stone burden, holmium laser parameters(high frequency and low energy), difficult stent implantation, postoperative ureteral stenosis, and postoperative intake of stoneexpelling drugs were factors influencing the stone residual rate after URHL(P＜0.05). The nomogram model showed area under the ROC curve(AUC)of 0.859(95%CI:0.789-0.913)in the training set and 0.808(95%CI:0.636-0.980)in the validation set. The calibration curves showed that the C-index was 0.921(95%CI:0.829-0.964)in the training set and 0.808(95%CI:0.636-0.980)in the validation set, indicating high consistency between the model-predicted probability of stone residual after URHL and the actual probability. Conclusion Daily water intake＜1000 mL, number of stones ≥3, maximum stone diameter ≥20 mm, stone burden ≥8000 mm , difficult stent implantation and postoperative ureteral stenosis are high-risk factors for stone residual. Holmium laser parameters(high frequency and low energy)and postoperative intake of stoneexpelling drugs are protective factors against stone residual. The nomogram prediction model can be used to predict stone residual after URHL.