OBJECTIVE: We aimed to compare the clinical outcomes of intravenous urography-assisted fluoroscopy-guided shockwave lithotripsy for radiolucent ureteral stones and standard shockwave lithotripsy for radiopaque ureteral stones. METHODS: We retrospectively reviewed 734 patients with ureteral stones treated by fluoroscopy-guided shockwave lithotripsy between March 2014 and March 2021. The primary outcome was a stone-free rate with one session within 30 days, defined as no residual stones without auxiliary treatment. The multivariate analysis was used to examine whether the intravenous urography use predicted treatment success. Furthermore, we compared the outcomes using propensity score matching. RESULTS: Ninety-eight patients underwent the intravenous urography use protocol (Group I), and the remaining 636 patients underwent the non-intravenous urography protocol (Group N). Stone-free rates with one session within 30 days were 38% and 32% in groups I and N, respectively ( CONCLUSION: Radiolucent stones can be safely and effectively treated by shockwave lithotripsy with intravenous urography.