Fifty-seven patients who could not be well handled by extracorporeal shock wave lithortripsy were treated with laser ureterolithotripsy using ureteroscope (6.9 Fr. or 7.2 Fr.) and Candela MDL-2 pulsed dye laser. Results showed tha the calculi in 53 patients (93%) were completely fragmented by laser used alone, while 2 (3.5%) needed adjuvant procedure (ESWL). There was only one immediate complication (pyexia). Therefore, ureteroscopy with laser lithotripsy was a safe and effective method for intracorporeal fragmentation of ureteral calculi; it is also a useful adjunct to ESWL.