This systematic review and meta-analysis aimed to determine the rates of ureteral stricture (US) following endoscopic treatments for urolithiasis and identify related risk factors. The study included 43 studies with patients aged ≥18 years who underwent endoscopic treatments such as ureteroscopy (URS), percutaneous nephrolithotomy (PCNL), or shock wave lithotripsy (SWL). The pooled US rates were 1.3% post-SWL, 2.1% post-PCNL, and 1.9% post-URS, increasing to 2.7% in the last five years and 4.9% if the stone was impacted. Patients with proximal ureteral stones, preoperative hydronephrosis, intraoperative ureteral perforation, and impacted stones had higher US risks. The overall US rate ranges from 0.3% to 4.9%, influenced by treatment type, stone location, and impaction. Future standardized reporting and extended follow-up studies are needed to better understand the risks associated with endoscopic treatments for urolithiasis.This systematic review and meta-analysis aimed to determine the rates of ureteral stricture (US) following endoscopic treatments for urolithiasis and identify related risk factors. The study included 43 studies with patients aged ≥18 years who underwent endoscopic treatments such as ureteroscopy (URS), percutaneous nephrolithotomy (PCNL), or shock wave lithotripsy (SWL). The pooled US rates were 1.3% post-SWL, 2.1% post-PCNL, and 1.9% post-URS, increasing to 2.7% in the last five years and 4.9% if the stone was impacted. Patients with proximal ureteral stones, preoperative hydronephrosis, intraoperative ureteral perforation, and impacted stones had higher US risks. The overall US rate ranges from 0.3% to 4.9%, influenced by treatment type, stone location, and impaction. Future standardized reporting and extended follow-up studies are needed to better understand the risks associated with endoscopic treatments for urolithiasis.