The main aim of this chapter is to evaluate the role of medical treatment of urinary stones. a-blockers could be of patient benefit when used for distal ureteral stones more than 5 mm in size. However, the quality of the randomized controlled studies on medical expulsive therapy is still low. Thiazide and thiazide-like agents as well as allopurinol are the best-studied drugs to prevent urinary stone recurrence, especially in calcium stone formers. The level of evidence on medical treatment of the non-calcium urinary stones is currently low. It is highly recommended to follow the European Association of Urology Urolithiasis Guidelines Panel Diagnostic and Therapeutic algorithms to prevent stone recurrence.