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Introduction To evaluate the efficacy and safety of preforming extracorporeal physical vibration lithecbole(EVPL)through greater sciatic foramen(GSF)for distal ureteral calculi(DUC) treatment. Materials and methods All patients with a diagnosis of DUC (6 - 10 mm in diameter) were enrolled in this study from October 2018 to May 2020. Patients were randomly divided into three groups receiving EPVL through GSF (Group A, n = 58), or abdominal (Group B, n = 60), or combined with oral use of tamsulosin at 0.4 mg daily (Group C, n = 63). Results There was no significant difference observed in terms of demographic characteristics or size of stones among the three groups (p >0.05). Compared with the group B and C, patients of the group A displayed a significantly higher score of comfort but with significantly decreased number of renal colic attacks or analgesics required (p < 0.01). The stone-free rate also significantly increased after one and two weeks of treatment (p < 0.01), despite such a significant difference among these groups vanished after four weeks of treatment. Conclusion Extracorporeal physical vibrational lithecbole in the prone position use the greater sciatic foramen as the path is the safe and effective approach to treat the distal ureter calculi.