Abstract: Objective To investigate the clinical effect of improved method with ureteral catheter-pressurized blood transfusion in the treatment of upper ureteral calculi by hard ureteroscopy. Methods A total of 130 patients with upper ureteral calculi from June 2016 to June 2018 in our hospital were included and randomly divided into two groups. In the experimental group (group A), 65 patients were treated with ureteral catheter (F4) placed above the calculi and pressurized with blood transfusion to keep instillation in the ureteroscope pneumatic lithotripsy. In Control group (group B), 65 patients were treated with conventional ureteroscope pneumatic lithotripsy and foreign body forceps. The results of operation time, stone clearance rate and postoperation complications were compared between the two groups. Results In group A, 5 patients were unable to insert ureteral catheter (F4) because of ureterostenosis. The other 60 cases were successful. Among the group of stone with diameter greater than 1 cm, a group of calculi clearance rate 92.9%, postoperative fever rate was 3.6%, and the operation time was (52.93±9.51) min. Those in group B were 70.0%, 26.7%, and (58.57±10.31) min, respectively. The above three groups of data comparison, the difference was statistically significant (all P<0.05), and perirenal fluid collection or ureteral injury incidence, the two comparison had no statistical significance (all P＞0.05). In the group with stone diameter less than or equal to 1 cm, the calculi clearance rate of group A was 100.0%, better than group B (80.0%), there was significant difference between the two groups (P<0.05). However, there was no statistical significance between the two groups in terms of operation time, postoperative fever rate, perirenal fluid collection and the incidence of ureteral injury (all P＞0.05). Conclusion The methods of ureteral catheter-pressurized blood transfusion is used in the treatment of upper ureteral calculi by hard ureteroscopy, which can effectively prevent stone drift, maintain a clear vision, shorten the operation time of large stones and reduce postoperative infection. This technology is worthy of clinical promotion in basic-level hospitals.