Uric acid stone disease is dependent on three pathogenetic factors: acid urine pH, low urine volume, and hyperuricosuria. The management of nonobstructing uric acid calculi should include maintenance of an alkaline urine, an increase in urine volume, and reduction in urinary uric acid excretion. It appears that potassium alkali may avoid the complication of calcium stone formation in patients with uric acid stones. In patients with obstructing uric acid calculi, more rapid dissolution may be accomplished with intravenous alkalinization or direct irrigation of the stone with an alkaline solution.