In order to explore the therapeutic effect of holmium laser and pneumatic lithotripsy on ureteric stones, as well as their effects on stress status and renal function, 100 patients with ureteral calculi admitted to the hospital from January 2021 to January 2023 were selected into a pneumatic lithotripsy group (n = 50) and a holmium laser lithotripsy group (n = 50). The results showed that Holmium laser lithotripsy had a significantly higher primary lithotripsy success rate (92.00%) than pneumatic lithotripsy (76.00%) (p < 0.05). However, a slightly higher postoperative stone clearance rate was observed in the pneumatic lithotripsy group with no significant differences between both groups. Significantly shorter operation time and average hospital stays were observed in the holmium laser lithotripsy group than in the pneumatic lithotripsy group. 3 days after surgery, C-reactive protein (CRP) and interleukin-6 (IL-6) levels in the holmium laser lithotripsy group were evidently lower than the pneumatic lithotripsy group. Holmium laser lithotripsy produced significantly lower malondialdehyde (MDA) levels (p < 0.05) and significantly higher superoxide dismutase (SOD) levels than pneumatic lithotripsy (p < 0.05). Both groups had similar preoperative renal function indexes (serum creatinine (Scr) and blood urea nitrogen (BUN)) (p > 0.05). Lastly, holmium laser lithotripsy had a considerably lower incidence of complications at 6.00% than pneumatic lithotripsy at 26.00% (p < 0.05). The results indicate that, compared with pneumatic ballistic lithotripsy, holmium laser lithotripsy can effectively improve the lithotripsy effect of ureteral stones, shorten the operation and hospitalization time, effectively reduce the inflammatory and oxidative stress status of the body, and effectively reduce the risk of postoperative complications.