Objectives To investigate the clinical effect of retroperitoneal laparoscopic ureterolithotomy (RLU) and percutaneous nephrolithotomy(PCNL) in the treatment of impacted upper urethral calculi.Methods 133 cases of impacted proximal urethral calculi were retrospectively analyzed in our hospital from January 2011 to September 2015.All patients were divided into RLU group (68 cases)and PCNL group(65 cases),and the effects of two groups were compared.Results The operation time of PCNL group (31.6 ±5.7) min,postoperative hospital stay (4.8 ± 1.0) d were significantly less than the RLU group (49.8 ± 8.2) min,(7.2 ± 1.5) d (P ＜ 0.05),bleeding volume of PCNL group (220.6 ± 40.0) mL,hospital expenses (20984 ± 2237) yuan were significantly higher than with RLU group (185.5 ±35.6) mL,(13098 ±1975) yuan (P ＜0.05).Proportion of patients with postoperative temperature(≥38℃),hemoglobin decreased value and stone clearance rate were no significant differences between the PCNL group and the RLU group(P ＞ 0.05).Serum CRP levels of PCNL group (3.28 ±1.47) mg/L,(27.85 ±9.29) mg/L,(13.06±6.14) mg/L were significantly less than RLU group (5.15 ± 1.72) mg/L,(34.98 ± 10.75) mg/L,(17.29 ±6.80) mg/L at 2,14,72 h (P ＜0.05).There was no difference in postoperative complications rate between PCNL group (18.46％) and RLU group (23.53％) (P ＞0.05).Conclusions RLU and PCNL in the treatment of impacted upper ureteral calculi have better clinical results,but PCNL has advantages of small incision,shorter operative time and quicker recovery.