The surgical emergency treatments and curative effects of postrenal acute renal failure following obstruction due to upper urinary calculi in infants were evaluated. Of the 13 infants with postrenal acute renal failure following obstruction due to upper urinary calculi, 11 received retrograded catheterizations of the ureter with semi-rigid ureteroscopy (F 6.8), and two received open ureterolithotomy. The results showed that only one infant had anuresis and continuous reduction of hemoglobin 5 h after the open ureterolithotomy and received exploration via excision and peritoneal dialysis, and the remaining 12 patients well recovered in this group. The renal function of all the patients was restored without postoperative complications. It is concluded that the retrograded catheterization of the ureter with ureteroscopy is a minimally invasive, safe and effective therapy for postrenal acute renal failure following obstruction due to upper urinary calculi in infants. For those infants whose urethras are thin and small, the open ureterolithotomy is a suitable method. But patients with bleeding tendency need to be corrected prior to the open ureterotomy to remove obstructions. © 2010 Higher Education Press and Springer Berlin Heidelberg.