INTRODUCTION: Medical Expulsive Treatment (MET) for ureteral stones has been questioned for the last few years. OBJECTIVES: The main goal of our study is to define the indications of MET, the different drugs that are used and their effectiveness and to propose a follow-up strategy. Secondary objectives include the effectiveness of MET in some special subgroups such as pregnant women and children and to assess aspects of MET cost-effectiveness compared with other options for ureteral lithiasis treat-ment (ureterorenoscopy or extracorporeal shock wave lithotripsy). MATERIAL AND METHODS: We have reviewed the most relevant clinical trials and meta-analysis evaluat-ing the impact of the different drugs available for MET. For the research we used some keywords like “medical expulsive treatment/therapy”, “ureteral lithiasis”, “uro-lithiasis”, “effectiveness”, “alpha-blockers” and “calci-um-antagonists”. MEDLINE database was used for the research (using the portal web Pubmed).RESULTS: Highest quality studies currently available show significant methodological limitations leading to heterogeneous and restricted evidence, which is only applicable to patients and lithiasis with specific condi-tions. Nevertheless, in general terms, it seems that MET can play a certain role in the expulsion of lithiasis ≥ 5 mm y ≤ 10 mm located in the distal ureter, although it has not been possible to demonstrate that any of the drugs used may have special superiority in terms of ef-fectiveness. In pregnancy and children, the recommen-dations of MET are also irregular. Finally, MET seems to be an alternative cost-effective compared to active options of treatment.CONCLUSIONS: Higher quality clinical trials are need-ed to reliably advice MET. With the current evidence, it appears that MET can improve the expulsion of distal ureteral lithiasis ≥ 5 mm and ≤ 10 mm, even though we have not found differences between the drugs that are available for MET.