Obstructive urolithiasis is a major health and productivity-limiting condition in male goats reared under intensive and semi-intensive production systems. The present study comparatively evaluated surgical interventions combined with standard medical management, with or without antioxidant therapy, on clinical recovery and oxidative stress in goats affected with obstructive urolithiasis. Twenty-four male goats presenting with partial or complete urinary retention were randomly allocated into four groups (n = 6 each). Goats with partial obstruction were managed by urethral process amputation followed by urohydropropulsion, whereas goats with complete obstruction underwent tube cystostomy. Antioxidant therapy (Lycopodium clavatum) was administered postoperatively in two treatment groups. Hematological, biochemical, electrolyte, and oxidative stress parameters were assessed before treatment and on day 4 post-treatment, along with clinical recovery indicators. Restoration of urine flow was achieved in all treatment groups; however, goats receiving antioxidant therapy showed significantly earlier clinical recovery and improved biochemical profiles. Antioxidant-treated groups exhibited greater reductions in blood urea nitrogen, serum creatinine, and malondialdehyde concentrations, along with significantly higher superoxide dismutase and catalase activities compared with non-treated groups (p < 0.05). Tube cystostomy combined with antioxidant therapy resulted in the shortest recovery period and the lowest incidence of postoperative complications. The findings indicate that urohydropropulsion is a feasible surgical option for partial urethral obstruction, while tube cystostomy remains effective for complete obstruction in goats. The inclusion of antioxidant therapy was associated with improved recovery and reduced oxidative stress, providing evidence-based guidance for optimizing the management of obstructive urolithiasis in goat production systems.