Background: The advent of various new techniques like ureteroscopy (URS), shock wave lithotripsy (SWL), and percutaneous renal surgery has revolutionized the treatment of ureteral calculi. However, these minimally invasive techniques have not been able to completely substitute for surgery in selected cases of large, hard, long standing, and impacted ureteral calculi, and retroperitoneal laparoscopic ureterolithotomy is the best choice for this cases.