Enteric hyperoxaluria is characterized by impaired intestinal fat absorption which leads to increased amounts of unabsorbed fatty acids and bile salts within the intestinal lumen. Unabsorbed fat and bile acids bind calcium, limiting the amount of free calcium available to bind with oxalate.163, 164 Consequently, a greater proportion of oxalate remains in a soluble (absorbable) form, leading to enhanced intestinal oxalate absorption, increased urinary oxalate excretion, and higher risk of calcium oxalate stone formation. For patients with enteric hyperoxaluria due to fat malabsorption (e.g., from inflammatory bowel disease, short gut syndrome, pancreatic insufficiency, or malabsorptive bariatric surgery), the goal of therapy is to reduce intestinal oxalate load and optimize luminal calcium-oxalate binding thereby limiting oxalate absorption and lowering urinary oxalate excretion.165, 166 To accomplish this, clinical guidelines and expert reviews consistently recommend dietary fat restriction, adequate calcium intake timed with meals, and calcium supplementation with meals if dietary calcium is insufficient to control urinary oxalate excretion.167, 168 For the purposes of binding oxalate in the intestinal tract, it is not necessary to prioritize the bioavailability of calcium (i.e., the absorption of calcium). This is because the ability of calcium to reduce oxalate absorption depends more on when it is consumed than on its absorption efficiency alone.169 The dosage of calcium supplements to be taken with meals should be titrated in each patient to achieve lower urinary oxalate; there is no one-size-fits-all approach. Calcium over-supplementation should be avoided. If these collective measures for controlling intestinal oxalate absorption are insufficient, lower dietary oxalate intake may be advised. However, this may result in lower consumption of magnesium, a nutrient of concern for individuals with fat malabsorption.170 Taken together, for adult and pediatric patients with calcium oxalate stones and enteric hyperoxaluria, measures should be implemented to reduce the bioavailability of dietary oxalate while maintaining optimal nutritional status and mitigating effects of fat malabsorption.