The prevalence of kidney stones is rising rapidly in the United States. Data from the Urologic Diseases in America project suggests that healthcare utilization and expenditures for treating patients with kidney stones are rising dramatically as well. Current understanding of treatment patterns is limited, but suggests that urologists are moving away from shock-wave lithotripsy and towards ureteroscopy for urinary stones that require intervention. Many opportunities exist for furthering our understanding of healthcare delivery for stones, including assessing quality of care, drivers of expenditures, and opportunities to maximize value for patients.