Purpose of Review <p>This review provides an overview of relevant technologies employed in the diagnosis and management of nephrolithiasis, including new and emerging technologies that are likely to change the ways in which nephrolithiasis is managed in the future.</p> Recent Findings <p>Although computed tomography (CT) is commonly utilized in the emergent diagnosis of nephrolithiasis, findings from recent studies suggest that an ultrasound (US)-first approach may reduce the need for CT imaging, potentially leading to a significant reduction in cost and radiation exposure for patients. Advanced imaging techniques such as dual energy CT, functional MRI, photoacoustic imaging, and shear-wave elastography are currently being developed that will continue to improve methods for the characterization of stone composition and the guidance of modern treatment approaches. Artificial intelligence (AI) systems may prove advantageous in enhancing diagnosis and provide valuable prognostic information.</p> Summary <p>While CT imaging is highly accurate in providing the diagnosis of nephrolithiasis and its complications, US evaluation can rapidly provide valuable clinical information. Emerging evidence has proven the benefit of US as the initial imaging modality of choice for many patients. Promising innovations in this field, including the use of AI, will likely continue to improve upon existing diagnostic techniques in the future.</p>