The pathogenesis and epidemiology of infection stones are well understood. While percutaneous lithotripsy and extracorporeal shock wave lithotripsy have emerged as the mainstay of extirpative therapy, surgical lithotomy is the standard to which other therapies must be compared. Adjunctive therapy with pharmacological agents that inhibit urease with few side effects and effective urinary acidifiers favor chemolysis. Diet and chemotherapy offer the hope of slowing stone growth and/or recurrence in patients with chronic urease-producing bacteriuria.