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Relevance. Urolithiasis is still one of the most widespread and actively progressing diseases. The high incidence of complications from taking chemical drugs has become the main reason for the change in attitudes towards herbal medicines, and now the treatment with herbal medicines is returning again, revealing its benefits based on evidence-based medicine. Phytochemicals have a positive effect on the gut microbiome and are widely used to prevent and treat obesity, liver, intestinal and inflammatory diseases. Materials and methods. The study involved 100 patients with a verified diagnosis of urolithiasis aged 25 to 78 years. The first group included 30 patients who underwent 1-2 sessions of extracorporeal lithotripsy (EBL) or percutaneous nephrolithotripsy (PCNL) for kidney stones up to 20 mm in size. The second group included 70 patients who were diagnosed with calculus during outpatient examination based on ultrasound and X-ray examinations. Each patient group was randomly divided into 2 subgroups. Patients of the subgroup  A - A1 and A2  received standard lithokinetic therapy - α-blockers, antispasmodics, adherence to daily urine output of at least 2 liters per day, if necessary, analgesic therapy with non-steroidal anti-inflammatory drugs. Patients of the subgroup  B - B1 and B2  received a similar therapy with the addition of dietary supplements  Nereus . During the observation period, an assessment of daily diuresis, fluctuations in the pH level of urine, clinical and laboratory studies of biochemical parameters of blood and daily urine, general clinical blood and urine tests, urine culture for flora and the degree of bacteriuria were carried out. To assess the severity of the pain symptom, a 10-point visual analogue pain scale (VAS) was used. Re-examination was performed after 1 and 3 months of treatment. Results. The use of the combined herbal preparation  Nereus  in lithokinetic therapy and metaphylaxis of urolithiasis reduces the need for analgesic and antispasmodic therapy, promotes an increase in urine output by 37%, maintains urine pH at physiological values, effectively reduces the level of leukocyturia and bacteriuria, accelerates the passage of stones and their fragments from various parts of the urinary tract. In all patients who took the herbal preparation  Nereus , there were no undesirable or side effects affecting the quality of life of patients. Conclusions. The study of the efficacy and safety of the drug  Nereus  in lithokinetic therapy and metaphylaxis of urolithiasis showed a significant effect of the phytocomplex on increasing urine output, eliminating the infectious-inflammatory process and passing stones from the urinary tract, good tolerance and absence of side effects.