Introduction: The first-line treatment of ureteric stones is done using (URS) and (ESWL). 
Pneumatic, electro-hydraulic, ultrasonic, and laser devices have been used for URS treatment . Small 
caliber ureteroscopes with laser lithotripsy are the traditional management for pediatric ureteral stones 
and have provided a more safe management with lower complication rates. Aim of the work: The 
aim of our study was to demonstrate the safety and efficacy of pneumatic lithotripsy in the 
management of ureteral stones in pediatric cases. Patients and Methods: Our prospective clinical 
study at Nephrology and Urology Minia University Hospital, involved semi-rigid ureteroscopy using 
pneumatic lithotripsy in 20 child with ureteric stones. All children (2-16 years old) attended at our 
outpatient clinic diagnosed with ureteric stones (< 15 mm in size) and indicated for surgery underwent
URS. Upper ureteric stones will excluded in our study. Results: In the current research, the outcome 
of 20 children underwent ureteroscopy with the use of a semirigid ureteroscope for middle and lower 
ureteric stones have been described. Our stone-free rate was 90%, all the complications were noted in 
our study at the start. We have not experienced any case of ureteral avulsion, there had been a single 
case of intraoperative ureteric perforation with extravasation. Regarding post-operative residual 
hydronephrosis , in our study 70 % of cases had no postoperative hydronephrosis on 1-month follow 
up US, while 100% of cases showed no hydronephrosis on 3-6 month follow up.