Purpose of review Management of pediatric urolithiasis has evolved from open surgery to minimally invasive techniques. With advancements in instrumention, endourological procedures are being performed more commonly in children. The current article reviews the literature published from January 2003 to September 2004 regarding endoscopic management of stones in children. Recent findings Whereas recent literature supports shock-wave lithotripsy as the preferred treatment option for pediatric stones, it also confirms the safety of percutaneous nephrolithotomy and ureteroscopy in all age groups. Retrograde intrarenal surgery and laparoscopic surgery are newer additions to the armamentarium of the endourologist but their role needs to be better defined. Summary The majority of stones in children can be managed using minimally invasive techniques. Proper treatment planning and use of appropriate instrumention are important to achieve optimal outcome.