The 2007 Guidelines for the Management of Ureteral Calculi suggested by the American Urological Association (AUA)/European association of Urology (EAU) have been followed as practice policy recommendations. However, some controversies still continue to evolve, and with technologic advancements, small-caliber semi-rigid ureteroscopes, flexible ureteroscopes, and newly developed intracorporeal lithotriptors have greatly improved the safety of ureteroscopy and success rates for proximal ureteral stones. As the national health insurance budget of Taiwan experiences a dilemma, lots of restrictions on urological treatments are being considered. The panel also recommends that extracorporeal shock wave lithotripsy be restricted to 3 sessions for a given stone refractory to treatment. Based on a literature review and expert opinions, this mini-review mainly focuses on changing strategies of managing proximal ureteral stones.