<p>Urolithiasis is associated with metabolic syndrome, and reactivation of brown adipose tissue (BAT) may improve metabolic syndrome. In this study, we aimed to evaluate the association of BAT, as detected using positron emission tomography-computed tomography (PET-CT), with urolithiasis in humans. This single center retrospective cohort study involved patients who underwent PET-CT for cancer screening as part of a medical checkup between January 2006 and December 2020. We obtained data on participant demographics, presence of urolithiasis, and metabolic factors (such as obesity, hypertension, diabetes, and hyperlipidemia) from 182 medical records. BAT data and calcification of the abdominal aorta (CAA) rate, determined using abdominal CT, were also recorded. Any association between urolithiasis and other factors was evaluated using logistic regression analysis. Body mass index was higher in participants with BAT than in those without BAT (26.92 vs. 22.86&#xa0;kg/m², <i>p</i> = 0.001). Participants with BAT had less urolithiasis and a lower CAA rate than those without BAT (10% vs. 37%, <i>p</i> = 0.031 and 50% vs. 79.6%, <i>p</i> = 0.008, respectively). Metabolic factors between the groups were similar (45.0% vs. 48.8%, <i>p</i> = 0.936). Furthermore, BAT and age were associated with a decreased odds ratio (OR) for urolithiasis (OR = 0.186, <i>p</i> = 0.037 and OR = 0.959, <i>p</i> = 0.02, respectively). We demonstrated that high BAT content is associated with a low risk of urolithiasis and CAA. Our findings may contribute to the development of novel preventive methods for urolithiasis.</p>