Objectives To comparre the therapeutic effect of ureteroscope with holmium laser lithotripsy combine with negative/non-negative pressure suction system.Methods The clinic data of 62 cases(from Jan.2009 to Aug.2012) of upper ureteral calculi by ureteroscope with holmium laser lithotripsy,before admission were indwelling nephrostomy fistula,twenty cases with residual ureteral calculi after percutaneous nephrolithotomy,35 patients with severe hydronephrosis were deal with nephrostomy drainage,and seven patients with upper ureteral calculi result in renal infection,62 cases underwent ureteroscope with holmium laser lithotripsy,In 30 cases(Group A) a negative pressure suction system was used.Without negative pressure suction system underwent in 32 patients(Group B).Renal fistula tube was connected with a urine dynamic detector.before and after operation test the Concentration of Na + and K +,record the time of operation,after 3 days,X-ray was used to test calculi.Results Operation was successfully completed in 62 patients,in group A,the average renal pelvic pressure was (93.46 ± 3.56)cmH2O,in group B,renal pelvic pressure was (201.13 ± 4.69)cmH2O,the two group have a significant difference(P ＜ 0.05),stone clearance rate was 98.72％,90.25 ％,there was no significant change in Na + and K + after operation.Conclusions Negative pressure suction system can reduce renal pelvic pressure,decrease the opportunity of fragments refluxed into the pelvis,had a positive meaning for decreasing the incidence of postoperational complications.