Objective: To explore the application effect of evidence-based nursing in the postoperative care of patients with ureteral calculi undergoing holmium laser lithotripsy, analyze its impact on the incidence of postoperative complications, the degree of stress response, and nursing satisfaction, and provide evidence-based support for optimizing clinical nursing practices. Methods: A total of 100 patients with ureteral calculi who underwent holmium laser lithotripsy in our hospital from January 2023 to June 2025 were selected and divided into an observation group (50 cases) and a control group (50 cases) using a random number table method. The control group received routine nursing interventions, while the observation group adopted an evidence-based nursing model. The incidence of postoperative complications (hematuria, urinary tract infection, renal colic, ureteral stricture), stress response indicators (heart rate, systolic blood pressure, diastolic blood pressure, Self-Rating Anxiety Scale (SAS) score, Self-Rating Depression Scale (SDS) score) before surgery and 24 hours after surgery, and nursing satisfaction were compared between the two groups. Results: The total incidence of postoperative complications in the observation group was significantly lower than that in the control group (p < 0.05). At 24 hours after surgery, the heart rate, systolic blood pressure, diastolic blood pressure, SAS score, and SDS score in the observation group were significantly lower than those in the control group (all p < 0.01). Nursing satisfaction in the observation group was significantly higher than that in the control group (p < 0.01). Conclusion: Evidence-based nursing can effectively reduce the incidence of postoperative complications in patients with ureteral calculi undergoing holmium laser lithotripsy, alleviate patients’ stress responses, and improve nursing satisfaction, demonstrating significant clinical application value.