Kidney stones are aggregates of microcrystals, most commonly containing calcium oxalate monohydrate (COM) as the primary constituent. The formation of these aggregates in the renal tubules of the kidney and their attachment to epithelial cells lining the renal tubules are thought to involve adhesion events between COM crystal surfaces and urinary species that bind to these surfaces. The pathological behavior of COM is in stark contrast to calcium oxalate dihydrate (COD), a different mineral phase commonly found in voided urine but much less frequently in stones, and whose presence is thought to protect against stone formation. This observation suggests that the structure and composition of calcium oxalate crystal surfaces and the fundamental interactions of these surfaces with urinary species are crucial to unraveling the complex pathology of this debilitating disease.