Ureteral stents are commonly used medical devices for the treatment of urinary system diseases. However, while providing benefits to patients, they often give rise to various issues, with stent encrustation being a major concern for clinical physicians. This phenomenon involves the formation of attached stones on the stent's surface, leading to potential complications such as increased fragility and laxity of the ureter, difficulties in stent removal, and a higher risk of stent fracture. Therefore, this review starts from the pathological mechanisms of stone formation and discusses in detail the two major mechanisms of stent encrustation: the conditioning film and the biofilm pathway. It also examines multiple risk factors associated with ureteral stents and patients. Furthermore, the review updates the research progress on the structure, materials, and bio-coatings of ureteral stents in the prevention and treatment of stent encrustation. It presents new insights into the prevention and treatment of stent encrustation. This includes individualized and comprehensive clinical guidance, the use of novel materials, and early intervention based on physiological and pathological considerations. Ultimately, the study offers an encompassing overview of the advancements in research within this field and provides the latest insights into strategies for preventing and treating stent encrustation.