BACKGROUND Urolithiasis is one of the most prevalent condition with evolving management strategies. While extracorporeal shock wave lithotripsy (ESWL) and ureteroscopic lithotripsy (URSL) are common minimally invasive treatments, their comparative efficacy, safety, and impact on quality of life (QoL) require continuous evaluation. AIM To compare the clinical efficacy, safety, patient satisfaction, and economic outcomes of ESWL vs URSL in the management of lower ureteric stones. METHODS This rand