Renal stone disease is one of the common diseases worldwide. Treatment of renal stones is widely variable. It changed markedly during the last three decades from the more invasive open surgery to the less invasive procedures such as shock wave lithotripsy, percutaneous nephrolithotripsy and recently retrograde intrarenal surgery. Though less invasive, these techniques are more commonly associated with residual fragments after therapy. Larger fragments are considered treatment failure and need re-treatment. Conversely, smaller fragments are usually clinically insignificant and might be considered acceptable outcome. Still, these insignificant fragments might become clinically significant or cause complications. In this article, we reviewed the available literature in a trial to report features of these residual fragments, their clinical significance, their incidence after the commonly performed minimally invasive renal stone therapy, the different imaging modalities used to detect these fragments, the fate of these fragment and the possible lines of management if these fragments are detected.
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