Renal stones are a common complaint and presentation of acute abdominal pain. Ultrasound is the initial modality for diagnosing. The smaller stones are more difficult to diagnose by ultrasound, which are easier to be diagnosed by CT, which is less available in all medical centers than ultrasound and Doppler. Color Doppler is the ultrasound-dependent modality for the assessment of the vascular system and blood flow, which has its own physics. Some types of artifacts are related to Color Doppler. Twinkle is one of them that can be helpful as a guide for the detection of small stones that makes its detection easier than detecting them by ultrasound alone. This can also decrease the need to expose patients to X-ray ionizing radiation of computed tomography to diagnose small stones not detectable by ultrasound alone, with no guidance of twinkle artifacts.