The prevalence of urolithiasis is steadily increasing with an estimation of 1 out of 11 people in the United States. The prevalence of calculi in Afro-Asian region including Arab Republic of Egypt ranges from 4% to 20%. Ureteroscopy is one of the first line treatments for definitive management of ureteric stones. Conventional ureteroscopy relies on intraoperative fluoroscopy for visualization and guidance, exposing the patient, surgeon and operating room staff to ionizing radiation. To minimize the hazards of ionizing radiation there has been a trend toward radiation free alternative imaging modalities . Ultrasound provides an excellent alternative for upper urinary tract imaging because it is radiation free, rapid, portable and allows excellent visualization of the renal pelvis and calyces. There is increasing awareness and concern about the clinical use of ionizing radiation and the need to decrease exposure of patients and medical professionals. Ultrasound guided ureteroscopy in pregnant females and children- in whom fluoroscopy is to be minimized or avoided when possible - has been reported.

Inclusion Criteria:

1. Patients with single symptomatic lower third ureteric radio-opaque stones indicated for endoscopic treatment.
2. Age group 18 years old or above.
3. Stone size 15 mm or less.

Exclusion Criteria:

1. Patients with bilateral ureteric stones
2. Ureteric congenital anomalies e.g. double ureter and ectopic ureter.
3. Previously failed ureteroscopy or previous ureteroneocystostomy.