Background: The management of ureteral calculi is constantly evolving, and advances in technology, new medications and the application of pharmacotherapy continue to alter our approach to ureterolithiasis. The optimal clinical management of patient with ureterlithiasis requires knowledge of the diagnostic procedures, the rational treatment of acute stone colic, stone expulsive treatment and the modern principles of stone removal. The aim of this study was to explore the clinical characteristics and management of ureterolithiasis. Methods: This cross-sectional descriptive study was conducted in the Department of Surgery and Urology, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from December 2013 to May 2014. Fifty eight patients with ureterolithiasis fulfilling the inclusion and exclusion criteria were selected. Results: The mean age of the patients was 36.0 ± 13.2 years, with the majority aged 31–40 years. All patients presented with abdominal pain, and 84.2% reported radiation of pain to the groin or genitalia. Other symptoms included nausea/vomiting (39.6%), hematuria (36.2%), and burning micturition (27.6%). Most stones (89.7%) measured between 1–2 cm. Treatments included ESWL (36.2%), ICPL (22.4%), open ureterolithotomy (31.0%), and expectant management (10.3%). Postoperative urinary tract infection occurred in 17.2% of cases; wound infection occurred in 11.1% of open surgery cases. Overall stone clearance was 86.2%, with the highest clearance in open ureterolithotomy (100%). Conclusion: With the availability of better facilities like Extracorporeal Shockwave Lithotripsy, the requirement for open surgery and interventional procedures may decrease.