Effective management of struvite calculi requires a comprehensive approach to eliminate the stone burden and prevent stone recurrence. These stones occur more frequently in women, infants, and the elderly, as these patients are at greater risk for urinary tract infections. All patients should have routine laboratory testing as well as an excretory urogram. Appropriate urine cultures should be completed. Definitive management should promptly follow diagnosis. Percutaneous nephrolithotomy with or without SWL is the usual treatment. Appropriate antibiotic use is helpful; magnesium and phosphorus restriction and administration of urease inhibitors are less valuable.