Abstract: Objective: To investigate the feasibility and safety of ureteroscopic lithotripsy for urgent decompression of urosepsis caused by acute obstructive ureteral calculiu . Methods: 35 consecutive patients diagnosed with ureteral stone-related sepsis received ureteroscopic lithotripsy as urgent decompression at our institution(29 patients of general sepsis,3 patients of sever sepsis,3 patients of sepsis shock) .Patients underwented ureteroscopic lithotripsy and placement of an indwelling ureteral double J stent under general or regional anesthesia. Results: All patients successfully underwent emergency drainage for decompression, and all cases improved after urgent decompression. There were no anesthesia related morbidities, postoperative exacerbations of the clinical condition, or postoperative deaths .Clinical outcomes(mean time to normal temperature and time to normal white blood count) :patients of general sepsis 1.6(0-7) days and 2.1(1-8) days; patients of severe sepsis 8.0(6-11) days and 9.3(7-13) days ; patients of septic shock 17.7(13-26) days and 19.7 (14-29) days .Conclusion: Ureteroscopic lithotripsy for urgent decompression of urosepsis caused by acute obstructive ureteral calculican can be safely and successfully performed by skilled endourologists in select clinical situations，such as patients of general sepsis, patients of severe sepsis and septic shock who fail to underwent primary retrograde indwelling double- J stent with cystoscope drainage and would have technically diffcuilty with mild hydronephrosis or with bleeding diathesis to perform percutaneous nephrostomy drainage.