Background: Rural hospitals in Australia face significant challenges due to limited access to radiology equipment, staff shortages, and overcrowding. Specifically, post-percutaneous nephrolithotomy (PCNL) patients often experience extended hospital stays while awaiting imaging to confirm ureteral patency before nephrostomy tube removal, exacerbating bed shortages and healthcare costs. This study explores the use of the bedside methylene blue nephrostogram (BMBN) as an alternative to advanced imaging methods to expedite patient discharge and alleviate resource strain in rural hospitals. Methods: BMBN involves the injection of methylene blue dye into the nephrostomy tube to confirm ureteral patency. The procedure is outlined in a step-by-step protocol, detailing pre-procedure preparation, injection technique, and post-procedure monitoring. Indications, contraindications, and troubleshooting are also addressed. Results: Two cases demonstrate BMBN's efficacy. In the first case, a 49-year-old male with complex urological anatomy successfully underwent BMBN, allowing for timely nephrostomy tube removal. A subsequent AN confirmed the result. The second case involved a 64-year-old male with a staghorn calculus, where BMBN similarly confirmed ureteral patency. Both cases highlighted the rapid, accurate, and cost-effective nature of BMBN compared to AN. Conclusion: BMBN is a safe, tolerable, and cost-effective procedure with no radiation exposure, providing a viable alternative to formal AN in confirming ureteral patency post-PCNL. Its integration into rural hospital protocols could significantly reduce hospital stay durations and associated costs. Further studies are warranted to compare BMBN with AN systematically.