Editor's Capsule Summary for Ferre et al(1) WHAT IS ALREADY KNOWN ON THIS TOPIC: Patients with ureteral calculi are often prescribed adjunctive treatment with an alpha-blocking agent to enhance spontaneous stone passage. This practice has not been validated in emergency department (ED) patients. WHAT QUESTION THIS STUDY ADDRESSED: Does the addition of a 10-day course of tamsulosin to standard therapy after discharge from the ED increase the rate of passage of distal ureteral stones? WHAT THIS STUDY ADDS TO OUR KNOWLEDGE: In this randomized trial of 80 patients, most of whom had stones of 4 mm or less, time to stone passage was similar in tamsulosin and control patients. HOW THIS MIGHT CHANGE CLINICAL PRACTICE: This study does not support the routine use of tamsulosin in ED patients, though it is possible that it would be beneficial in patients with larger stones.