ABSTRACT Background: Stone in the urinary tract has been challenge to human being since the dawn of the history. Research over years has shown that the incdence of bladder calculi has reduced and incidence of upper urinary tract calculi has gone up slowly. With developments in different radilogical modalities, the diagnosis of calculus disease has become more accurate and the better understanding of physiochemical principles underlying the stone disease , chemical composition of urinary calculi with advent of medical therapy have shown rays of hopes to the scientists for prevention of stone diseases. Method: The present series is a study of 48 patients admitted with urinary calculi in Acharya Vinoba Bhave Rural Hospital, Sawangi Meghe during the period of two years (August 2008- July 2010). Results:In this it was observed that urinary calculi were most commonly seen in age groups from 21-30 years (19 cases) 39.50% and 31-40 years (13 cases) 27.33%, respectively followed by age groups from 41-50 years (5 cases) having incidence of 10.34%, with incidence of ureteric calculi was more i.e. 54 calculi as against renal calculi i.e. 38 calculi; bladder calculi i.e. 07 calculi and urethral calculi i.e. 03 calculi. It was observed that urinary calculi were more common in patients having mixed diet (66.7%) as compared to vegetarian diet (33.33%) and were more common in patients having milk (95.8%) in their diet as compared to patients not having milk (4.2%) in their diet. Blood urea levels were raised in 04 cases (8.33%) suggestive of altered renal functions. Serum creatinine was done in selected cases whenever indicated. 3 cases show the deranged creatinine. Urinary pH was acidic in 44 out of 48 cases i.e. 91.66% as against neutral and alkaline pH in 2 and 2 cases i.e. 4.16% and 4.16%, respectively. Urinary infection was present in 22 out of 48 cases i.e. 45.83% cases. Bacteria were present in 20 cases i.e. 41.66% cases. Microscopic Hematuria was present in 26 cases i.e. 47.91% cases. Albumin was present in 28 cases i.e. 58.33% cases. Crystals were detected in urine in 21 cases, out of which 18 were made up of calcium oxalate (37.5%), 1 were made up of triple phosphate (2.08%) and 2 were made up of uric acid (4.16%). Plain X Ray KUB could detect 96 urinary calculus out of 102 (i.e. 94.11% calculus identified). Hydrotherapy was done in 2 cases of ureteric calculi. Both Patients passed calculus in the ward 48-72 hours after starting hydrotherapy. Nephrectomy was done in 1 case of non- functioning kidney. Nephrolithotomy was done for 5 calculi. Extended pyelolithotomy was done for 5 calculi. Pyelolithotomy was done for 27 calculi.All cases were treated with antibiotics, daily-dressings and secondary suturing. Urinary leak occurred in 1 case. That case was treated conservatively. The urinary leak stopped with conservative management. One patient had secondary hemorrhage. The patient was treated conservatively. Follow-up Out of 48 cases, 35 cases came for follow-up in Out Patient Department. Thus, follow-up rate was 72.91%. Conclusion: Despite of limited resources and lack of recent techniques of ESWL, PCNL and Endourology multiple Urolithiais can be managed at rural setups