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Background: Urinary stone disease is a prevalent health issue worldwide, with varying incidence influenced by multiple factors. This study aims to provide the first comprehensive analysis of urinary stone composition in Azerbaijan., Methods: A retrospective study was conducted on 1465 patients, aged 1‒83 years, who underwent biochemical urinary stone analysis at the Department of Renal Diseases and Organ Transplantation, Azerbaijan State Security Service Military Hospital, between April 2015 and December 2023. Stone samples were analyzed using Fourier transform infrared (FTIR) spectroscopy. Statistical analyses were performed using the IBM® SPSS software version 29.0., Results: The cohort had a median age of 45 years, with a male-to-female ratio of 1.65:1. Calcium oxalate stones were the most common (56.2%), followed by uric acid (33.7%), struvite (5.3%), cystine (2.5%), calcium phosphate (1.9%), and xanthine (0.1%) stones. Men had a higher prevalence of calcium oxalate and uric acid stones, while women had more struvite stones. Mixed stones were common, particularly among uric acid and struvite stones. Significant differences in stone composition were observed between age groups and genders, with uric acid stones found predominantly in older individuals., Conclusion: This study highlights the predominance of calcium oxalate stones and the elevated prevalence of uric acid stones in Azerbaijan, emphasizing the need for tailored diagnostic and therapeutic approaches. The high prevalence of mixed stones underscores the complexity of urinary stone disease and the need for comprehensive metabolic evaluation and individualized preventive strategies., (© 2024 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)