Purpose: We assessed the efficacy and safety of external physical vibration lithecbole for the treatment of residual stones after retrograde intrarenal surgery. Materials and Methods: A total of 173 patients (128 males and 45 females) were selected for study. All patients had residual fragments after retrograde intrarenal surgery for renal or upper ureteral stones. They were prospectively randomized into 2 groups. One group underwent external physical vibration lithecbole 1 week after retrograde intrarenal surgery and the other underwent only retrograde intrarenal surgery as the control group. Stone size and location, stone-free rate and complications were compared. Results: Of 173 patients 87 (66 males and 21 females) were in the treatment group and 86 (62 males and 24 females) were in the control group. The stone-free rate in the treated and control groups 2 weeks after retrograde intrarenal surgery was 52.9% and 31.4%, at 3 weeks it was 71.3% and 51.2%, and at 5 weeks it was 89.7% and 59.3%, respectively (all p < 0.05). The hematuria incidence 5 weeks after retrograde intrarenal surgery was 3.4% in the treated group compared to 20.9% in the control group (p < 0.05). The incidence of positive urine leukocytes in the treated vs control groups was 4.6% vs 19.8% 3 weeks after retrograde intrarenal surgery and 3.4% vs 11.6% at 5 weeks (p < 0.05). Conclusions: External physical vibration lithecbole as a supplement to retrograde intrarenal surgery was more effective than retrograde intrarenal surgery alone in terms of stone clearance speed, stone-free rate and patient compliance.