Introduction. Urolithiasis (kidney stone disease) is a chronic, polyetiological disorder affecting up to 10–15% of the world’s population. The incidence is steadily increasing: over two decades, it has risen by 37% in high-income countries, and over 30 years, the number of cases has grown by 41.89%. The disease is characterized by frequent recurrences and a close association with metabolic syndrome, necessitating a systematic evaluation of current risk factors. Objective. To systematize and analyze the risk factors for urolithiasis based on clinical guidelines, systematic reviews, meta-analyses, genome-wide association studies (GWAS), and relevant publications. Materials and Methods. A literature review was conducted for the period 2020–2026. Meta-analyses, cohort studies, GWAS, guidelines, clinical recommendations of professional associations (ROU, EAU, AUA, IAU), scientific publications from the eLibrary (RSCI), PubMed, and Cochrane Library databases were included. The search was conducted using keywords. The data are grouped into categories of non-modifiable, modifiable, and local risk factors. Results and Discussions. International research has identified 71 genetic loci associated with urolithiasis. The prevalence is higher in men (12.93%) than in women (8.91%). Risk factors increasing the likelihood of stone formation include: high body mass index (relative risk (RR) 1.39; 95% CI: 1.27–1.52); excessive sodium intake (RR 1.38; 95% CI: 1.21–1.56); consumption of meat and animal proteins; fructose and sugar-sweetened beverages; and vitamin D supplementation as monotherapy (RR 1.22; 95% CI: 1.01–1.49). Factors associated with a reduced risk include: adequate fluid intake (RR 0.55; 95% CI: 0.51–0.60); the Dietary Approaches to Stop Hypertension (DASH) diet (RR 0.69; 95% CI: 0.64–0.75); dietary calcium intake (RR 0.83; 95% CI: 0.76–0.90); and consumption of vegetables, fruits, dietary fiber, coffee, and tea. Genetic testing is recommended for patients with hyperoxaluria ≥80 mg/day. Long-term urolithiasis is associated with a 10–23% recurrence rate and a possible increased risk of renal cell carcinoma. Conclusions. The leading modifiable risk factors, require targeted intervention: dehydration, excess sodium, animal protein consumption, and obesity. Genetic testing is indicated for high-risk patients. Adequate hydration (2.0–2.5 L/day), the DASH diet, and weight normalization are the cornerstones of prevention. Multidisciplinary management of patients with urolithiasis and metabolic syndrome is recommended.