Abstract Background: Several different techniques including guide-wire lasso, simple snare, modified snare (MS) and direct grasping (DG), are available for retrograde ureteral stent retrieval and exchange. Choice among them is not always easy and depends on many different factors, including the local level of expertise. Objective: To compare the MS and DG during retrograde exchange of double-J ureteral stent under fluoroscopic guidance. Settings and Design: 66 patients (36 men and 30 women; mean age 66.6 years) needing retrograde ureteral stent exchange were included. All stents were previously placed through an anterograde way. Materials and Methods: Time needed to grasp each single stent was recorded as well as the complications.Statistical Analysis: Fisher′s test was used to compare procedural time in both groups; P < 0.05 was considered significant. Results: 102 stents were exchanged. Mean time was 4.46 min for DG and 7.81 min for MS (P = 0.029). No significant complications were encountered. Conclusions: Compared to the MS, the DG is easier, quicker, and less expensive.