Ureteral access sheaths can have a nonuniform axial-stiffness. A nonuniform axial-stiffness ureteral access sheath can have an inner liner defining a longitudinally extending and generally uniform bore. A non-uniform axial-stiffness outer jacket can define a longitudinally tapered outer surface, and a reinforcement layer can be encapsulated between the inner liner and the non-uniform axial-stiffness outer jacket. The reinforcement layer can have a non-uniform axial-stiffness. For example, a proximal portion of the reinforcement layer can be thicker than a distal portion of the reinforcement layer. A coil of wire can be included in the reinforcement layer, and a diameter of the wire in a proximal portion of the reinforcement layer can be larger than a diameter of the wire in a distal portion of the reinforcement layer. In some instances, the diameter of the wire tapers from the proximal portion to the distal portion.