The objectives of the present research were to conduct a survey to investigate the health history and feeding practices of giraffe in captivity in North America and to obtain samples of hay, concentrate, browse, urine, and serum to compare across zoos, possible factors relating to the development of urolithiasis. Forty-one out of 98 institutions contacted responded, representing 218 giraffe. All responding zoos fed concentrate and alfalfa hay was the primary forage. Sixty five percent of zoos fed browse and 43 different species of browse were listed. Six zoos reported a history of urolithiasis, seven reported wasting syndrome, and 10 reported sudden death. The median daily amount (as fed) of concentrate and hay offered were 5.45 kg (range of 2.73–9.55 kg) and 6.82 kg (range of 2.53–12.50 kg), respectively. The concentrate:hay ratio of the offered diet ranged from 0.22 to 3.47 with a median value of 0.79. Forty-three percent of the institutions offered a ratio greater than 1:1. Samples of concentrate and hay (six zoos), serum (five zoos), and urine (seven zoos) were obtained for chemical analyses. Analyzed nutrient content of the consumed diet, measured by weighing feed and orts for three consecutive days, met recommendations for giraffe, but was excessive for crude protein and P. Concentrate:hay and serum P were positively correlated (r = 0.72; P < 0.05). High dietary P content and a high level of concentrate relative to hay may be contributing factors to urolith formation and warrant further investigation.