INTRODUCTION: Ureteric stone is one of the most common urological presentation in surgical emergency department. In last decade medical expulsive therapy (MET) has been used in management of distal ureteric stones as conservative treatment because it would significantly reduce the medical cost and prevent unnecessary invasive We evaluated the efficacy of nifedipine and alfuzosin in the medical treatment of symptomatic, uncomplicated distal ureteral stones. METHODS: The prospective study was done on the patients who presented with uretric stones. Patients ≥8 years of either sex with a single, unilateral ureteral stone of ≤10 mm were included. Patients were randomly divided into two equal groups of 50 patients each. Patients in Group I received tablet nifedipine 30 mg/day, Group II received alfuzosin 10 mg/day. Patients were followed up weekly up to 28 days; history of stone passage, number of pain episodes were recorded and investigated with routine urine examination, kidney function test,and X‑ray KUB .The findings in both groups were compared and statistically tabulated. RESULTS: Group I had 62% male and 38% female (mean age: 33.28±7.17 years) and Group II had 58% male and 42% female (mean age: 32.19±9.26 years). The mean stone size was 6.3 ± 1.49 mm for Group I and 6.41±1.64 mm for Group II. A statistical significant difference was observed for stone expulsion rate between Group I versus Group II (58% vs. 78%, P<0.05). Average time for stone‑expulsion was 12.7±5.48 days in Group I and 12.6±55.3 days in Group II with statistically insignificant difference. Patients taking alfuzosin had fewer pain attacks compared with others. The average number of pain attacks was 2.98±0.98 for Group I and 1.77±0.71 with significant statistical difference. Hospital re‑admissions due to uncontrollable pain occurred in 28% and 16% of the subjects in group I and II respectively CONCLUSION: Medical expulsion therapy is a useful adjunct to observation in the conservative management of ureteral stones. The use of alfuzosin and nifedipine for uncomplicated distal ureteric stones is safe and effective in term of increased stone‑expulsion rate, reduced pain attacks and decrease hospital re‑admissions. Alfuzosin was found to be significantly better in terms of stone‑expulsion rate and pain attacks as compared to nifedipine