Nephrolithiasis is considered rare in pediatrics. Information available is not sufficient to establish its prognosis with certainty. The purpose of this research was to describe the signs, symptoms, complications and recurrence shown by pediatric patients with urolithiasis. Medical records of pediatric patients with urolithiasis were identified for the period from 2003 to 2009. Sixty patients were included, out of which 26.2 % had some comorbidity and 31 % had a family history of lithiasis. The cardinal symptom was abdominal pain (65 %) and the most important sign was gross hematuria (46.6%). 72.9 % had some metabolic abnormality (predominantly hypercalciuria), 97.9 % received medical and 70 % surgical treatment. Diet modification was the most widely used medical treatment (95.7%). In 52 % initial treatment was surgical. During the follow-up, 18.7% recurred and 12 % had renal failure. The most common clinical conditions were abdominal pain, gross hematuria and dysuria. The most common metabolic cause was hypercalciuria, whereas the most common structural cause was ureteropielic stenosis. About 15 % recurred and 12 % were at risk of progression to kidney failure.