One of the most fearful rare complication of ureteroscopic lithotripsy is sepsis. Since sepsis after endourological maneuvers usually occur immediately after procedure, it is important to pay attention to symptoms representing sepsis such as pyrexia, tachycardia, tachypnea, and oliguria. In addition to clinical symptoms, laboratory tests including white blood cell (WBC) count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and urine and blood cultivating can help to diagnosis of sepsis. We present a case of shock after ureteroscopic lithotripsy, which was suspected with septic shock strongly.