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Purpose: This study investigates gender-based disparities in health-related quality of life (HRQOL) outcomes among kidney stone patients and explores potential contributing factors. Methods: A retrospective review of medical records at the University of Rochester Medical Center was conducted on 2199 new urolithiasis patients who completed the Wisconsin Stone Quality of Life Questionnaire (WISQOL) standardized on a 0 to 100 scale. Demographic and clinical data were collected. Statistical analyses included univariate tests, chi-squared tests, and multivariate linear regression. Results: Of the 2199 kidney stone patients, 1085 (49.3%) were women. Women reported significantly lower quality of life (QoL) scores compared with men (71.6 vs 80.7; p < 0.001), and this persisted across all domains, including social impact (80.2 vs 86.9; p < 0.001), emotional impact (67.3 vs 77.1; p < 0.001), disease impact (67.3 vs 77.1; p < 0.001), and impact vitality (62.6 vs 72.9; p < 0.001). Female gender was identified as an independent predictor of diminished QoL scores, along with younger age, symptomatic status, number of surgeries, and presence of a psychosocial comorbidity. Conclusions: Our findings suggest that women with kidney stones experience lower HRQOL compared with men, even accounting for clinical and demographic factors. Although this study provides preliminary insights, additional research is needed to validate these findings in broader and more varied populations. [ABSTRACT FROM AUTHOR]