Alhunaidi O, Ahmad AA, EL-Nahas AR, et al. - Two invitations to complete an internet survey were emailed to Endourological Society members in order to report recent global variation in techniques and clinical practice of flexible ureteroscopy (FURS) among endourologists of various case volumes per year. Responses were received from 146 endourologists worldwide. FURS for intrarenal stone > 20 mm was used by 61% of high-volume surgeons vs 28.6% for low-volume. Semirigid URS was used for upper ureteric stones in 68% and 82% among the high-volume group and in the low-volume group, respectively, and ureteral access sheath was used by 62% and 69% in the low-volume group vs the high volume group. Laser stone dusting was favored by 63% vs 45% in low-volume group vs high-volume. More responders in the low-volume group favored leaving the stent for 6 weeks. In conclusion, for treating upper tract calculi, the use of FURS has extended by high volume endourologists to incorporate large renal stones > 20 mm. Moreover, for the treatment of upper ureteral stones, low-volume surgeons prefer to use semi-rigid URS in order to apply Laser stone dusting and maintain ureteral stents for longer periods.