Conclusions:Patients with neurogenic bladder are traditionally thought to harbor infection related calculi. These data demonstrate that many contemporary patients will be found to have calculi of a metabolic etiology. Although patients with NB still have renal calculi, advances in urological treatment may have affected the composition of their calculi, as metabolic stones are becoming more commonly identified. When metabolic components are identified, stone activity may be attenuated with appropriate metabolic evaluation, pharmacological therapies and dietary modifications.