Objectives: To determine the efficacy of Tamsolusin Hydrochloride as medical expulsive therapy in removal of lower ureteric calculi < 9 mm in adults. Study Design: Cross-sectional study. Setting: Naz Memorial Hospital Karachi. Period: July 2019 to December 2019. Material & Methods: Using non-probability convenient sampling technique was conducted for 6 months. After ethical approval patients attending outpatient department with complains of bloody urine, abdominal, flank or groin pain and diagnosed as lower ureteric calculi < 9mm on ultrasonography. Upper ureteric or kidney calculi above 9 mm, patients already on Tamsolusin and lost to follow up or not willing to participate were excluded. Time period of the study was 4 weeks. Patients were started on Tamsolusin 0.4 mg once daily for 30 days. SPSS version 23.0 was used for data analysis. Qualitative data was reported as frequency in percentages. Results:  Age range of patients was 18-50 years with mean age of 35.54 ± 10.20 years. 48 (40%) between 6 to 7 mm. After 1 month of follow up, total of 94 (78%) of patients were found to have expulsion of ureteric calculi. From the total of 30 days, the recorded frequency of calculi expulsion was 94 (78%). Among them, 25 (27%) patients were reported to have expulsion of calculi in between 15 to 19 days.32 (34%) patients between 20-24 days, while 37 (39%) patients between 25 to 29 days. Conclusion: Tamsolusin was significantly effective in expulsion of calculi with most calculi reported to be expulsed between 20-29 days of treatment. Patients also reported in significant decrease in pain frequency and were satisfied with treatment with Tamsolusin for lower ureteric calculi < 9mm.