Objective To investigate the application effect of multi-dimensional model intervention guided by root cause analysis (RCA) in perioperative management of patients with ureteral calculi. Methods A total of 194 patients with ureteral stones admitted to the Department of Urology at Kaifeng 155th Hospital from July 2023 to December 2024 were enrolled. Using a random number table, they were divided into a conventional group (receiving routine perioperative nursing interventions) and a study group (receiving RCA-guided multidimensional interventions), 97 cases in each group. The postoperative recovery, psychological state, complications, quality of life and nursing satisfaction of the two groups were compared. Results The first exhaust time in the study was significantly earlier than that in the conventional group (P＜0.05), the hospitalization time was significantly shorter than that in the conventional group (P＜0.05), the postoperative visual analogue scale (VAS) score and the incidence of complications were significantly lower than those in the conventional group (all P＜0.05), and the nursing satisfaction was significantly higher than that in the conventional group (P＜0.05). After 2 and 4 weeks of intervention, compared with the routine group, the scores of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) in the study group decreased (all P＜0.05), the score of the world health organization quality of life instrument, BREF version (WHOQOL-BREF) increased (P＜0.05). Conclusion Applying RCA-guided multi-dimensional model intervention to the perioperative management of patients with ureteral calculi can not only reduce the incidence of complications and promote postoperative rehabilitation, but also alleviate patients’ anxiety and depression, improve their quality of life and nursing satisfaction. This study provides evidence for nursing practice in the perioperative management of ureteral calculus.