Medical Expulsion Therapy (MET) is a non-surgical treatment option with the goal to facilitate the passage of ureteric stones. This approach uses medication to relax the ureteric smooth muscle thus reducing pain and assisting the stone’s expulsion. The medications used have been alpha-blockers, calcium channel blockers, corticosteroids, and, latterly, phosphodiesterase type 5 inhibitors. The effectiveness of α-blockers in MET has been supported by some meta-analyses, although their use for this purpose is still off-label. However, evidence from other, well-designed, multicenter, placebo-controlled, double-blinded randomized trials suggest limited or no benefit from α-blockers. Additional studies, involving a limited number of patients, so far, do not strongly support the combination of calcium channel blockers with α-blockers in MET, whilst the use of combination therapies including phosphodiesterase inhibitors, and corticosteroids, may, potentially, be beneficial for the conservative management of distal ureteric stones 5–10 mm in size.