Fifty-one cases of Verapulse holmium laser treatment of various urological conditions are presented. The laser was easy to use and was equally effective through fluid and carbon dioxide media for soft tissue ablation, lithotripsy and laparoscopic surgery. The laser demonstrated precision haemostatic cutting and was particularly suited to superficial ablation of lesions in the bladder and urethra and for the fragmentation of ureteric calculi. Its minimal depth of penetration (less than 0.5 mm) meant that conventional diathermy and lithotripsy techniques are still superior for the cutting of large volumes of tissue and for the fragmentation of large renal calculi. In three patients the holmium-YAG laser was able to ablate small superficial recurrent tumours using sedo-analgesia alone. We feel this laser warrants further investigation as an urological laser and may have applications in other fields of endoscopic surgery.