Kidney stones affect up to 13% of the population, with a significant risk of recurrence that can impact quality of life. Universal preventive measures include dietary modifications, such as increased fluid intake, reduced salt, and limited dietary purines, alongside lifestyle changes. Pharmacological treatments include potassium citrate, thiazide diuretics, allopurinol and sodium bicarbonate. Potassium citrate plays a dual role by inhibiting calcium oxalate and uric acid stone formation while increasing urinary pH. Thiazides effectively reduce hypercalciuria, and allopurinol lowers urinary uric acid levels, benefiting calcium oxalate and uric acid stone formers. Sodium bicarbonate causes urinary alkalinisation.