Background: Ureteral strictures following ureteroscopic procedures for stones are becoming increasingly prevalent. This study aims to compare the incidence and risk factors of post ureteroscopic ureteral strictures Vs Extracorporeal Shock Wave Lithotripsy (ESWL) for ureteral stones. Methods: A retrospective analysis was conducted on patients who had ureteral stones and underwent either ureteroscopy with laser lithotripsy or ESWL for treatment. Data regarding stone size, impacted stones, duration of stone presence in the ureter, ureteroscope size “diameter”, if prior ureteral stent is done, laser machine settings and lasing time were collected. Results: Ureteral strictures were significantly more common post ureteroscopy with laser lithotripsy compared to ESWL. Risk factors for stricture includes larger stone size, impacted stones, longer stone presence in the ureter, acute ureteroscopy without prior stenting for large stones, larger ureteroscopes diameter, longer lasing time and improper laser machine settings. Conclusion: ESWL remains a non-invasive alternative to ureteroscopy with laser lithotripsy and is associated with a lower incidence of ureteral strictures. Proper patient assessment for selection of the right procedure, Competent training in laser machine operation and settings are crucial to minimize complications post ureteroscopy.