Renal calculus disease remains a significant health problem in our population. Improvement in our ability to treat patients with kidney stones has shifted the focus away from patient evaluation. The modern stone age has seen the development of endourologic techniques and shock wave lithotripsy, and many clinicians take a more cavalier approach to the identification of etiologic factors and to the development of preventative strategies. This article reviews the various laboratory and imaging modalities that are available and the rationale for their use.