Abstract: Objective To investigate the severe complications of ureteroscopic pneumatic lithotripsy （UPL） and their preventive measures. Methods Complications of UPL and their managements were retrospectively analyzed. Results Ureteral perforation, ureterostoma injury, ureteral submucosa pseudocanal, ureteral rupture, and avulsed ureter injury were found in 3, 2, 3, 1, and 1 patients, respectively. Conclusion Complication of ureteroscopic fetching calculi operation is closely related with the technical manipulation of operator. The key to decrease such complications is the experience of operators.