PURPOSE OF REVIEW: Ureteroscopy continues to improve as a method for management of intrarenal stone disease. The development of new technologies and enhanced application of existing therapies is expanding the indications of ureteroscopy for the management of renal calculi. RECENT FINDINGS: Improvements in image quality have been achieved with the adoption of digital ureteroscopes. Modifications of standard ureteroscopic techniques and improvements in surgical skill training are also being made. Ureteroscopy is demonstrated to be well tolerated and efficacious for the management of intrarenal calculi in multiple-patient populations and is also cost-efficient. SUMMARY: The indications for ureteroscopic management of renal calculi are expanding, and this technique is quickly being adopted as a routine option for the management of intrarenal stone disease.