【Abstract】 Objective To observe and compare the efficacy of ureteroscopic holmium laser lithotripsy (URL) under local anesthesia and general anesthesia and continuous epidural anesthesia. Methods 90 patients with ureteral calculi admitted to department of urinary surgery of our hospital from February 2017 to February 2019 were selected for the study, and given selective URL surgery. According to different anesthesia methods, they were divided into local anesthesia group, general anesthesia group and continuous epidural anesthesia group, with 30 cases in each group. The perioperative vital signs [mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SpO2) ], operative time, hospital stay, postoperative recovery of gastric function, stone clearance rate, stones returning to kidney and incidence rate of complications were recorded and compared among the three groups. Results The HR during operation in the three groups was increased while the MAP was decreased, and the HR in local anesthesia group was significantly lower than that in general anesthesia group and continuous epidural anesthesia group, while the MAP was significantly higher than that in general anesthesia group and continuous epidural anesthesia group (P＜0. 05). After operation, the HR and MAP in local anesthesia group returned to normal, but the HR in general anesthesia group and continuous epidural anesthesia group was still higher than that before operation while the MAP was still lower than that before operation (P＜0. 05). There was no statistically significant difference in the SpOz during perioperative period among the three groups (P > 0. 05). The operative time, hospital stay and postoperative recovery of gastric function in local anesthesia group were significantly shorter than those in general anesthesia group and continuous epidural anesthesia group, and the proportion of stones returning to kidney and the incidence rate o£ complications were significantly lower than those in general anesthesia group and continuous epidural anesthesia group (P＜O. 05). Conclusion URL under local anesthesia for ureteral calculi can maintain stable perioperative vital signs, and it has low requirements for cardiopulmonary function, good surgical tolerance ,the gastrointestinal function recovered quickly after operation, high stone removal rate and few complications.