Objective To study the efficacy and safety of retroperitoneal laparoscopic ureterolithotomy (RLUL) and mini-percutaneous nephrolithotomy (MPCNL) in the treatment of upper ureteral calculi. Methods A retrospective analysis was made of the clinical data of 84 patients with upper ureteral calculi, who were treated at the Urology Department of Qionghai People′s Hospital from January 2021 to January 2022. According to the surgical interventions employed, they were divided into RLUL group (n=40) and MPCNL group (n=44). The two groups were compared in the perioperative indicators. SPSS statistics 19.0 was used for data analysis, and independent sample t test,χ²test or Fisher exact test was performed for inter-group comparison, depending on data type. Results Compared with MPCNL group, the RLUL group had longer surgical time [(64.06±10.74) vs (40.53±9.52) min], higher hemoglobin level after surgery [(145.69±15.33) vs (136.76±14.86) g/L], shorter ambulation time [(2.03±0.43) vs (4.46±0.94) d] and retention time of drainage tube [(5.21±0.89) vs (7.36±1.25) d], and lower incidence of postoperative high fever (0.00% vs 13.64%), the difference being statistically significant (P<0.05). There were no statistical differences between the two groups in stone clearance rate (100.00% vs 97.73%), urethral catheter retention time [(5.46±1.07) vs (5.71±1.32) d] and postoperative hospital stay [(6.15±1.65) vs (6.53±1.49) d; P>0.05]. No ureteral stricture or stone recurrence occurred in the two groups during post-operative follow-up of 6-10 (7.58±1.06) months. Conclusion Both MPCNL and RLUL have good effects and high safety in the treatment of incarcerated upper ureteral calculi. It is recommended to select the appropriate surgical mode according to the specific conditions of patients.