We examined the feasibility of performing ureteroscopy under sedation only. Twenty-eight ureteroscopies performed with sedation only were compared to 18 performed in an operating room setting. Durability towards the procedure was good in 86 % of the cases. Stone-free rates were 42 and 72%, respectively. Fifty-seven percent of the patients required hospitalization with the most common complication being low-grade fever. Although our success rate is less favorable for sedation only, this setting is feasible, and in nearly half of the patients hospitalization was avoided with no need for an expensive operating room facility. Careful patient selection, a sharp learning curve and small-french instruments combined with pneumatic lithotriptors may also improve the results.