Pakistan Medical Research Council (PMRC) has sponsored a multicentre research on the status of urolithiasis in Pakistan. The survey of the distribution of stones from various parts of Pakistan has not so far shown any regional variations. Aetiology of calculous disease still remains obscure. Various studies report higher incidence rate in summer. Stone formation in 50 to 65% Pakistani patients with urolithiasis and recurrence in 12.1%. Small stones can be treated with high fluid intake and urinary infection with appropriate antibiotics whereas obstruction needs surgical treatment.