Abstract. Objective:This study aims to compare the cytotoxicity and adhesion difference between oxalate monohydrate (COM) and dehydrate (COD) crystals and African green monkey kidney epithelial cells (Vero). Methods: Through the detection of cell viability, lactate dehydrogenase (LDH) release amount, expression of hyaluronic acid, and propidium iodide staining method to compare the cell injury degree; scanning electron microscope was used to observe crystal adhesion. Results: Cellular damage increased as time extended within 1~12 h. The cytotoxicity of COM was stronger than COD, and the adhesion amount of COM was much larger than COD. Conclusions: The formation of large amount of micron-sized COM crystals during short time in urine will produce cytotoxicity to kidney epithelial cells, which increasing the risk of stone formation, In contrast, the formation of COD cause relatively less cytotoxicity.