The upper and mid ureteric stones are the most difficult to treat stones. Because of their chances of drifting back into the renal pelvis during fragmentation. In the present study, we compared the results of holmium laser lithotripsy with the pneumatic lithotripsy in terms of effectiveness, need of ancillary procedure, re-treatment rates and complications. Material and Methods: This retrospective study was done in two institutes over a period of two years. Group 1 included 80 Ho:YAG laser lithotripsy patients and group 2 included 80 pneumatic lithotripsy patients. The stone clearance was confirmed at 4 weeks and presence of fragments ≤ 2mm were considered as free of stone. Statistical analyses were done by using the Student t-test and Chi-square test. Results: The mean age of the patients in group 1 was 45.82 years and 46.42 years in the group 2. The stone clearance was higher in the group of Ho:YAG laser (p = 0.038). The ancillary procedures were fewer in the Ho:YAG laser group (p = 0.542). There was statistically significant difference in the mean fragmentation time and the duration of the procedure in both the groups. There was severe retropulsion in ten patients in the pneumatic lithoclast group. Conclusion: Holmium:YAG laser lithotripsy and lithotripsy with pneumatic lithoclast are safe procedures for upper/mid ureteric stones. Laser lithotripsy is better and recommended for larger stones as compared to the pneumatic lithotripsy because of lesser stone migration. Both have comparable complication rate.