Urolithiasis is a common problem in children. Its incidence has increased. Evaluation for metabolic and anatomical abnormalities is important in children. Medical treatment includes analgesics, antiemetics, urinary alkalinization and if required, IV fluids. In selected children, medical expulsion treatment with nifedipine/tamsulosin is an effective and safe modality. Decreased water intake, high salt and meat product intake are major factors contributing to recurrence. Modification of risk factors and follow-up are of prime importance.