Introduction. Urolithiasis is a global medical and social problem characterized by a steady increase in prevalence and incidence worldwide. The modern paradigm views nephrolithiasis not as an isolated urological pathology, but as a disease closely associated with systemic metabolic disorders, which creates a significant burden on healthcare systems. Objective. To systematize current epidemiological data on urolithiasis, analyze key demographic and geographic trends, and evaluate the evidence-based associations of urolithiasis with comorbid conditions and risk factors to form a comprehensive understanding of the disease. Materials and methods. An analytical review of scientific literature was conducted, including data from large population-based studies (NHANES, European and Asian registries), systematic reviews, and meta-analyses from recent decades. The analysis focused on prevalence and incidence rates, demographic correlates, the role of diet, and data on metabolic disorders in patients with urolithiasis. Results and discussion. A global increase in the prevalence of urolithiasis has been established, with the highest rates in developed countries and "stone belt" regions. Incidence is increasing across all age groups, including the pediatric population. Clear demographic patterns were identified: age dependence, a narrowing gender gap, and ethnic variations. Convincing evidence of the association between urolithiasis and obesity, metabolic syndrome, type 2 diabetes mellitus, cardiovascular diseases, and chronic kidney disease was obtained. Key dietary factors (hypohydration, excess sodium and animal protein, low dietary calcium intake) and urinary metabolic disorders (hypercalciuria, hyperoxaluria, hypocitraturia) underlying the pathogenesis were identified. The results confirm that urolithiasis is a marker of systemic metabolic disorders. The rise in incidence may be driven by changes in diet, lifestyle, and global climate change. The identified associations underscore the need for a multidisciplinary approach to patient management that extends beyond urological treatment. Conclusion. Urolithiasis has transformed into a widespread disease with pandemic features, inextricably linked to the epidemic of metabolic syndrome. Effective prevention and treatment require a comprehensive strategy aimed not only at stone removal but also at correcting diet, metabolic disorders, and comorbid pathology. Further research should focus on investigating the causes of the global increase in urolithiasis and developing population-based prevention programs.