Objective The aim of this research is to study the prevalence of urolithiasis among the population of Sarawak Malaysia and the associated risk factors. Patients and Methods A survey was conducted among individuals aged ≥18 years age in three primary health care clinics in the main cities of Sarawak from March 2019 to March 2020. Participants underwent face‐to‐face interview using a predesigned and standardised questionnaire. Details on demographic data, comorbidities, dietary variables and lifestyle were collected. Ultrasonographic examination of the kidney, ureter and bladder was performed followed by blood and urine sampling. Prevalence was defined as the proportion of participants with kidney stones, and univariate logistic regression was used to estimate the associated factors. Results A total of 1087 participants (486 male, 601 female) completed the questionnaire. Ultrasonographic examination and laboratory investigation were carried out, with an overall response rate of 98.8%. The prevalence of ultrasonographic proven urolithiasis in the sample studied was 4.04%. The mean age of patients with urolithiasis was 50.05 (SD 14.6, range 18–89), and the male to female ratio was 1.2: 1. Univariate analysis showed that odd ratio of personal history of urolithiasis (0.16, p:0.00), salty food intake (0.39, p:0.02), family history of urolithiasis (0.39, p:0.01), and hypertension (1.77, p:0.04) was significantly associated with a greater risk of urolithiasis. Conclusion The prevalence of urolithiasis in this study population is 4.04%. It affects males and females equally; 61.4% are in the age group of 25–64 years. Hypertension, high salt diet, personal history of urolithiasis and family history of urolithiasis are significant risk factors.