A medical imaging and therapy device is provided that may include any of a number of features. One feature of the device is that it can deliver Lithotripsy therapy to a patient, so as to fractionate urinary stones. Another feature of the device is that it can deliver Histotripsy therapy to a patient, so as to erode urinary stones. In some embodiments, the medical imaging and therapy device is configured to target and track urinary stones in the patient during therapy. Methods associated with use of the medical imaging and therapy device are also covered.