A novel hydrodynamic-driven stability analysis is presented for surface patterns on speleothems, i.e., secondary sedimentary cave deposits, by coupling fluid dynamics to the geochemistry of calcite precipitation or dissolution. Falling film theory provides the solution for the flow-field and depth perturbations, the latter being crucial to triggering patterns known as crenulations. In a wide range of Reynolds numbers, the model provides the dominant wavelengths and pattern celerities, in fair agreement with field data. The analysis of the phase velocity of ridges on speleothems has a potential as a proxy of past film flow rates, thus suggesting a new support for paleoclimate analyses.