Abstract: Objective：To analyze the difference in the efficacy of extracorporeal shock wave lithotripsy（ESWL） in the treatment of upper ureteral calculi by transthoracic and dorsal ultrasound.Methods：260 patients with upper ureteral stones treated with ESWL were randomly divided into two groups.The ventral ultrasound was used as the observation group，and the dorsal ultrasound was used as the control group.Ultrasound positioning，therapeutic effect，differences in postcomplications were compared between the two groups.Results：The distance between the observation group and the skin was（3.8±1.3）cm，which was significantly lower than that of the control group[（8.2±2.4）cm]（P<0.05）.The stone location time of the observation group was（5.2±2.4）min，which was significantly shorter than the control group[（12.1±3.2）min]（P<0.05）.The primary clearance rate of the observation group was 90.0%，which was significantly higher than that of the control group（80.0%，P<0.05）.The secondary treatment rate of the observation group was 10% and the three treatment rates were 0，which were significantly lower than the control group（20.0% and 7.7%，respectively），all P<0.05.There was no significant difference in the number of hematuria，renal hematoma and urinary infection between the two groups（P>0.05）.Conclusion：Transthoracic ultrasonography is more accurate than traditional dorsal localization，which is beneficial to further improve the ESWL efficacy of upper ureteral stones，and has high safety.It is worthy of clinical application.

Key words: ultrasonography, extracorporeal shock wave lithotripsy, upper ureteral stones, efficacy