Objective To investigate the long-term safety and efficacy of Allium self-expanding covered stent in the treatment of complex ureteral stricture. Methods A retrospective analysis was performed for the clinical data and long-term follow-up results of 22 patients with ureteral stricture who underwent Allium self-expanding covered stent implantation in The First Affiliated Hospital of Chongqing Medical University from April 2020 to December 2021. The paired samples t-test was used for normally distributed key indicators，and the non-parametric test of related samples was used for non-normally distributed key indicators. Results A total of 22 patients with ureteral stricture who underwent Allium self-expanding covered stent implantation were included based on strict exclusion criteria，with a mean age of （48.3±10.6） years and a median follow-up time of 36.5 months. The time of operation was 86（35-270） minutes，and there were no serious complications in the perioperative period. Follow-up results showed that the covered stent remained in place and unobstructed in 17 patients（77.3%），among whom 16 patients showed disappearance of hydronephrosis at the end of follow-up and 1 patient was improved from severe hydronephrosis to mild hydronephrosis. One patient underwent robotic ureteral reconstruction after removal the stent due to unrelieved hydronephrosis. The stent was removed in 4 patients due to the complication of calculus，among whom 1 had no hydronephrosis after stent removal，1 had alleviation of hydronephrosis，and the other two patients still had severe hydronephrosis and unobstructed urine excretion without the symptom of lumbago. No serious surgical complications or serious stent-related symptoms were observed during follow-up. The mean concentration of serum creatinine was （103.6±31.1） μmol/L before surgery，which decreased to （102.2±27.7） μmol/L at the end of follow-up（P=0.942）. The maximum width of hydronephrosis was （5.9±2.1） cm before surgery and （1.7±1.2） cm after surgery（P=0.000）. The maximum width of hydronephrosis was （0.35±0.25） cm at the end of follow-up，which was significantly different from that after surgery（P=0.001）. Conclusion Allium self-expanding covered stent can effectively improve hydronephrosis in the treatment of complex ureteral stricture. There are relatively low incidence rates of complications such as stent symptoms，pain，and infection，and it can be retained for a long time to reduce the frequency of stent replacement.