Calcium stones is responsible for 80 per cent of the stones in the upper track. It is a frequent and particularly recurrent disease and for this reason it is important to prevent its recurrence by medical treatment, dissolution of calcium stones being impossible. In the first part of this review, we have presented the theoretical basis and the clinical studies concerning conservative therapy involving high fluid intake and dietary advice on calcium and oxalate intake. Then, for the various drugs proposed for recurrence prevention we have reviewed their mechanisms of action and the controlled clinical trials concerning these drugs. Finally, the practical therapeutical choices for the management of these patients are presented according to the results of the previous metabolic evaluation.