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Abstract Objective：To investigate the surgical skills and the clinical effect of L5-L3 impacted ureteral stones treated with transureteroscopic holmium YAG laser lithotripsy.Method：56 patients from march 2013 to October 2014 diagnosed with impacted ureteral stones were treated with transureteroscopic holmium YAG laser lithotripsy.the size of stones were from 0.7 cm×0.5 cm to 1.6 cm×0.8 cm.Result：The fragmentation rate in single procedure was 92.9% （52/56），one case was conversed to open surgery due to the severity tortuosity of ureter that led to failed ureteroscope insertion。The stones of three cases slipped into the renal in the process because of stones harder.the mean operation time were 28 min。the mean postoperation hospital stay time were three days。The complications did not take place in and after operations such as ureter perforation、ureterodialysis、renal rupture、hyperthermia and sepsis。Conclusion：The clinical result of the L5-L3 impacted ureteral stones that were treated with transureteroscopic holmium YAG laser lithotripsy is satisfactory.If you want to avoid the operative complications and enhance clinical effect，you should play attention to surgical skills.
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