Objective: To systematically evaluate of the safety and effectiveness of flexible ureteroscope negative pressure sheath in the treatment of renal calculi. Methods: Wanfang, VIP and CNKI databases were retrieved by computer and manually searched to obtain relevant Chinese documents, and PubMed and Web of Knowledge databases were retrieved with the same methods to obtain relevant English documents. The search date was from Month 2010 to March 2020. The Chinese search terms include “flexible ureteroscope negative pressure sheath, flexible ureteroscope and renal calculi” and so on. Subsequently, literature screening, data extraction and quality evaluation were carried out, and the data in the relevant documents obtained were divided into FURS group and RIRS group. Results: There was no statistical significance difference in the hospitalization time, the number of steinstrasse and the number of hematuria in the FURS group and RIRS group (P>0.05), the stone clearance rate in FURS group was higher than that in RIRS group (P<0.00001, OR=2.99, 95%CI: 2.05 to 4.34), the operation time was shorter than that in RIRS group (P<0.00001, MD=−19.71, 95%CI: −27.18 to −12.24), the number of fever after operation was lower than RIRS group (P<0.00001, OR=0.23, 95%CI: 0.13 to 0.42). Conclusion: The application of soft ureteroscopy negative pressure sheath in soft ureteroscopy surgery can increase stone clearance rate, reduce postoperative fever, and reduce operation time, with obvious advantages.