Background: Extracorporeal shockwave lithotripsy (ESWL) and ureteroscopic lithotripsy (URSL) are two popular therapeutic modalities used when conservative or medical expulsive therapy for upper ureteric stones fails. Present study was aimed to compare between ureteroscopic lithotripsy vs extra corporeal shock wave lithotripsy in the management ofupper ureteric calculi. Material and Methods: Present study was prospective, observational study, conducted in patients > 20 years, diagnosed to have Upper ureteric stone of size 6 mm to 15 mm (L2 level to Upper border of sacrum), radio opaque stone. The decision was made based on the patient’s choice for either ESWL or URS. Results: Total number of patients included in our study was 81. Most of the patients belonged to the age group of 20 – 30 years (37 %). Male: female ratio was 5.2: 1. Majority of patients had a stone size of 6 – 10 mm (53.1%) as compared to stone size of 11 – 15 mm (46.9 %). Out of the 81 patients, 84 % had successful stone clearance. Upper ureteric stones of sizes 6 – 10 mm were cleared in 93% casesand ureteric stones of sizes 11 – 15 mm were cleared in 73.7 % cases; difference was statistically significant. URSL had an overall success rate of 88.2 % while ESWL had an overall success rate of 76.7 % (23/30).URSL was successful in 27/28 (96.4 %) patients with stone sizes 6 – 10 mm and 18/23 (78.3%) patients with stone sizes 11 – 15 mm. ESWL was successful in 13/15 (86.7 %) patients with stone sizes 6 – 10 mm and 10/15 (66.7 %) patients with stone sizes 11 – 15 mm. Conclusion: Both procedures (Laser URSL and ESWL) can be safely and effectively used as a primary treatment for radio-opaque stones in proximal ureter of sizes 6 to15 mm. Keywords: Laser URSL, ESWL, Stones in Proximal Ureter, Stone Free Rat

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