Objective: A meta-analysis to determine the effect of alpha-blockers on distal ureteral calculi regarding clearance rate and expulsion time. Methods: Medline, EMBASE and the Cochrane Library were explored. Retrieved abstracts were selected and assessed on relevance and validity by two independent authors using predefined criteria. Results: from a total of 867 articles 17 were selected. 11 full-text articles were included for data-analysis after critical appraisal. These studies, all performed in urological clinics at the early phase symptoms, showed a more favorable effect of alpha-blockers compared to the control group. The studies showed heterogeneity in type and doses of alpha-blockers. Pooled results regarding expulsion rate showed a risk difference of 33% (95% Cl: 25%-40%) in favour of alpha-blockers. Subgroup analysis of tamsulosin 0.4 mg showed a risk difference of 35% (95% Cl: 25%-45%). The mean difference regarding expulsion time was 5 (95% Cl: 4-6) days in favour of alpha-blockers. Subgroup analysis of tamsulosin 0.4 mg showed a mean difference of 5 (95% Cl: 4-7) days. Second, we found a 38-89% decrease of pain episodes and a 30-34% decrease in need for analgesics. Conclusion: Treatment with alpha-blockers in patients with distal ureteral calculi appears to shorten the expulsion time and increase the expulsion rate.