Kidney stone disease (KSD) is a common urological condition with a rising incidence, particularly in North America, Europe, and Asia. It is characterized by the formation of mineral deposits in the kidneys, primarily composed of calcium oxalate (CaOx) or calcium phosphate (CaP). The disease has a high recurrence rate, with up to 50% of patients experiencing recurrence within five years of the first stone formation. The pathophysiology of KSD involves supersaturation of urine, leading to crystal nucleation, growth, and aggregation, which can result in stone formation. The process is influenced by various factors, including diet, gender, and environmental conditions. Genetic predisposition and epigenetic modifications also play a role in stone formation. Modifiable risk factors such as BMI, fluid intake, calcium intake, and sugar-sweetened drink consumption are important in preventing KSD. Non-calcium-containing stones, such as uric acid and struvite stones, are also significant, with different mechanisms of formation. The diagnosis of KSD involves imaging techniques like CT and ultrasound, along with laboratory tests to determine the stone composition. Prevention strategies include lifestyle modifications, dietary changes, and pharmacological treatments tailored to the type of stone. Recurrence prevention is crucial, with the ROKS model predicting the risk of future stone episodes based on various factors. Effective management requires a multidisciplinary approach, including dietary counseling, medication, and monitoring. Future research focuses on understanding the role of the urinary microbiome, epigenetic factors, and novel therapeutic approaches to improve outcomes for patients with KSD.Kidney stone disease (KSD) is a common urological condition with a rising incidence, particularly in North America, Europe, and Asia. It is characterized by the formation of mineral deposits in the kidneys, primarily composed of calcium oxalate (CaOx) or calcium phosphate (CaP). The disease has a high recurrence rate, with up to 50% of patients experiencing recurrence within five years of the first stone formation. The pathophysiology of KSD involves supersaturation of urine, leading to crystal nucleation, growth, and aggregation, which can result in stone formation. The process is influenced by various factors, including diet, gender, and environmental conditions. Genetic predisposition and epigenetic modifications also play a role in stone formation. Modifiable risk factors such as BMI, fluid intake, calcium intake, and sugar-sweetened drink consumption are important in preventing KSD. Non-calcium-containing stones, such as uric acid and struvite stones, are also significant, with different mechanisms of formation. The diagnosis of KSD involves imaging techniques like CT and ultrasound, along with laboratory tests to determine the stone composition. Prevention strategies include lifestyle modifications, dietary changes, and pharmacological treatments tailored to the type of stone. Recurrence prevention is crucial, with the ROKS model predicting the risk of future stone episodes based on various factors. Effective management requires a multidisciplinary approach, including dietary counseling, medication, and monitoring. Future research focuses on understanding the role of the urinary microbiome, epigenetic factors, and novel therapeutic approaches to improve outcomes for patients with KSD.