Objective: To explore the clinical effect of retroperitoneal laparoscopic ureterolithotomy (RLU) for mid-upper ureteral calculi and to study the effect on stress reaction and renal function. Methods: A total of 160 patients with mid-upper ureteral calculi in Sichuan 81 Rehabilitation Center from January 2015 to June 2016 were enrolled in this study. Eighty patients in the observation group were treated with RUL and 80 patients in the control group were treated with percutaneous nephrolithotomy (PNL). The situation of operation and postoperative complications were compared and the changes of stress reaction and renal function indexes were observed. Results: The operation time in the observation group was longer than that in the control group, while the blood loss, time in bed and hospital stay in the observation group were significantly shorter than those in the control group (P<0.05). There was no significant difference in stone clearance rate between two groups (P>0.05). The levels of CRP, endothelin-1 (ET-1), cortisol (Cor) and serum creatinine (SCr), cystatin C (CysC), neutrophil gelatinase-associated lipocalin (NAGL) increased significantly in the two groups (P<0.05) and those indexes in the observation group were significantly lower than those in the control group (P<0.05). The occurrence rate of postoperative complications in observation group was lower than that in control group (P<0.05). Conclusion: Compared with PNL, RLU has exact effect in treating mid-upper ureteral calculi. It has great advantages of less blood less, rapid recovery, high stone clearance rate and less postoperative complications. The effects of RLU on stress reaction and renal function are small.