<p>The global incidence of nephrolithiasis has increased significantly in recent decades. The prevalence remains higher in males than females, the exact mechanisms responsible for this gender-based disparity in nephrolithiasis risk remain incompletely understood. Although dietary and lifestyle factors contribute to this difference, they do not entirely account for the observed variation. Emerging evidence suggests that steroid hormones may play a pivotal role in modulating renal stone formation through their influence on calcium, oxalate, and phosphate metabolism, as well as regulating the renal inflammatory microenvironment. This review synthesizes current knowledge on the interplay between steroid hormones and nephrolithiasis pathogenesis, providing a theoretical framework for understanding gender-specific susceptibility and highlighting potential avenues for tailored preventive and therapeutic approaches.</p>