OBJECTIVE: To compare the effectiveness and safety of percutaneous nephrolithotripsy (PCNL) and ureteroscopic lithotripsy (URSL) in treating proximal ureteral stones. METHODS: The clinical data of 86 patients with proximal ureteral stones, admitted to the Department of Urology at the First People's Hospital of Chun'an County from May 2021 to May 2023, were retrospectively analyzed. Patients were divided into a PCNL group (n=41) and a URSL group (n=45) based on the treatment modality. Key outcomes compared between the two groups included surgical time, intraoperative blood loss, incidence of complications, hospital stay, stone clearance rate, lithotripsy success rate, renal function indicators, and levels of inflammatory factors. RESULTS: The PCNL group had significantly higher intraoperative blood loss and longer postoperative hospital stay compared with the URSL group, whereas the operative time was remarkably shorter ( CONCLUSION: Both PCNL and URSL are effective treatments for proximal ureteral stones. However, PCNL offers superior clinical effectiveness and safety.