Objective: To explore the clinical value of Shuo Tong ureteroscopy in the treatment of upper urinary tract stones with pyonephrosis. Methods: The data of 106 patients with upper urinary tract calculi combined with pyonephrosis who underwent Shuo Tong ureteroscopy treatment in our department from October 2016 to February 2018 were retrospectively analyzed. All patients underwent elective surgical treatment after definitive diagnosis. The operation time, length of stay, tone free rate, postoperative fever and complications were observed. The period was 1 month. Results: All operations were successful. The operation time was 27–65 (37±12) minutes. The total hospitalization time was 3–7 (4.3±2.1) days. Two cases had postoperative fever (≥38.5 °C); 1 patient developed urinary sepsis after operation. After the timely application of hydrocortisone, Tienam, rehydration and other symptomatic treatments, the patient’s condition eventually recovered. The KUB or CT examination on the first postoperative day and 1 month after the operation suggested that the rate of stone clearance was 81.1% (86/106) and 96.2% (102/106), respectively; 4 patients still indicated residual stones were completely discharged after 2nd stage Flexible ureteroscope or lithotripsy supplemented with extracorporeal shock wave lithotripsy. In 6 cases, the ureteral stricture was found during the operation. The ureteral stent was replaced after 1 month and the rest patients was removed. All patients had no major bleeding, renal insufficiency, perirenal hematoma, ureteral stone street, avulsion, perforation and other serious complications. All patients were cured and discharged after active symptomatic treatment. Conclusion: The use of Shuo Tong ureteroscopy for the treatment of upper urinary tract obstructive pyonephrosis has a significant clinical effect, high rate of Stone free, and the clinical effect is safe and reliable. It can be popularized and applied.