Background: Ureteric stones, a common condition affecting individuals across the world, often lead to significant morbidity due to symptoms such as severe pain, hematuria, and urinary tract infections. The aim of this study was to evaluate the role of radiological and inflammatory markers in predicting the spontaneous passage of mid and lower ureteric stones. Material and Methods: This prospective observational study was conducted at a tertiary care hospital with 110 patients diagnosed with unilateral mid or lower ureteric stones. The inclusion criteria comprised adults aged 18-65 years, with a single radio-opaque ureteric stone, confirmed by non-contrast computed tomography (NCCT) or ultrasonography (USG). The primary outcome was spontaneous stone passage within 4-6 weeks, confirmed by follow-up NCCT or USG. Secondary outcomes included the association of inflammatory markers (CRP, ESR, WBC count) and radiological factors with spontaneous passage. Results: Among the 110 patients, 72.73% experienced spontaneous stone passage, while 27.27% required surgical intervention. The majority of stones were <5 mm in size (54.55%). Elevated CRP, ESR, and WBC count were observed in a significant proportion of patients. A strong correlation was found between stone size, hydronephrosis, and the spontaneous passage of stones. Follow-up revealed a progressive increase in stone expulsion rates from 60% at 2 weeks to 85% at 6 weeks. Conclusion: This study demonstrates that smaller stone size, absence of hydronephrosis, and elevated inflammatory markers like CRP, ESR, and WBC count significantly predict the spontaneous passage of mid and lower ureteric stones. These findings assist clinicians in predicting stone expulsion and determining the need for surgical intervention.