Objective: To improve endoscopic recognition of the most frequently encountered kidney stone morphologies for a better etiological approach in lithiasis by urologists.Materials and methods: An expert urologist intra-operatively and prospectively (between June 2015 and June 2018) examined the surface, the section and the nucleus of all encountered kidney stones. Fragmented stones were subsequently analysed by a biologist based on both microscopic morphological (i.e. binocular magnifying glass) and infrared (i.e. FTIR) examinations (microscopists were blinded to the endoscopic data). Morphological criteria were collected and classified for the endoscopic and microscopic studies. The Wilcoxon–Mann–Whitney test was carried out to detect differences between the endoscopic and microscopic diagnoses. A diagnosis for a given urinary stone was considered "confirmed" for a non-statistically significant difference.Results: A total of 399 urinary stones were included in this study: 51.4% of the stones exhibited only one morphological type while 48.6% were mixed stones (41% had at least two morphologies and 7.6% had three morphologies). The overall matching rate was 81.6%. Diagnostics were confirmed for the following morphologies: whewellite (Ia or Ib), weddellite (IIa or IIb), uric acid (IIIa or IIIb), carbapatite-struvite association (IVb), brushite (IVd).Conclusions: Our preliminary study demonstrates the feasibility of using endoscopic morphology for the most frequently encountered urinary stones and didactic boards of confirmed endoscopic images are provided. The current study constitutes the first step toward endoscopic stone recognition, which is essential in lithiasis. We provide didactic boards of confirmed endoscopic images which paves the way for automatic computer-aided in-situ recognition.Read less <