Objective To describe the initial clinical experience with the UreTron (Med-Sonics, Erie, PA), a new ultrasonic lithotriptor. Historically, ultrasound-only intracorporeal lithotriptors have been considered the gold standard for stone removal during percutaneous nephrolithotomy. Recently, they have lost favor to newer dual and combination devices believed by many to be more efficient. The UreTron features patented technology to precisely control probe vibration and achieve more efficient output potentially improving efficiency of stone clearance. To date, the clinical efficacy of this new device has yet to be tested relative to alternative state-of-the-art lithotriptors. Methods Thirty-one patients with renal stones >2 cm undergoing percutaneous nephrolithotomy were studied. All cases were performed by the same surgeon, and data were recorded prospectively using the same protocol established for a separate ongoing comparison study designed to assess performance of 3 separate state-of-the-art lithotriptors (CyberWand, StoneBreaker, and LithoClast Select). Bivariate analysis was performed between the UreTron cohort and the combined cohort of the alternative state-of-the-art lithotriptors (n = 51). Results The UreTron achieved the highest stone clearance rate (51.9 mm2/min) of any device. It also had little decrease in clearance efficiency when used on "hard" stones (48.5 mm2/min). The UreTron had a faster clearance rate than the alternative lithotriptor cohort (51.9 vs 36.0 mm2/min; P =.02) with no differences in stone-free rate, secondary procedures, clinical complications, or device malfunctions (P >.05). Conclusion The UreTron compares favorably with alternative state-of-the-art intracorporeal lithotriptors with faster stone clearance rates and equivalent clinical outcomes.