ObjectiveThis study aimed to analyze different therapeutic modalities used in the treatment of urolithiasis in the Democratic Republic of Congo.ResultsAmong the 194 patients included in this study, 69% (n=133) were males, with a male to female ratio of 2.2: 1, and an age mean (SD) of 48.1 (17.3) years. Urolithiasis was symptomatic in 52.6% (n=141) of patients. Renal colic was the most common clinical expression. Overall, 86.1% (n=167) of stones were removed by surgery, 9.8% spontaneously resolved, 3.1% were extracted after ureteroscopy, and 1% of patients had undergone extracorporeal shock wave lithotripsy. Lumbotomy was the most frequent used route (39.2%) in conventional surgery. The mean (SD) size of the extracted stones was 23.4 (17.0) mm.Most patients in this study were treated by conventional surgery. These results suggest the need to increase the use of minimally invasive surgery.