Background <p>Kidney stone is the major cause of morbidity, and its prevalence is increasing in the world. Kidney stone disease is a common cause of morbidity, and its prevalence is increasing in the world. This study aimed to determine the prevalence of kidney stone disease and to evaluate the correlation between drinking water sources (tap and tube-well) and various demographic, dietary, and clinical factors among adult attendees of Rajshahi Medical College Hospital (RMCH).</p> Methods <p>This cross-sectional study was performed from January to June 2024 at the inpatient and outpatient departments of RMCH in Rajshahi City, Bangladesh. The data was collected by face-to-face interview with a well-structured questionnaire directly. SPSS (IBM version 23) was used for data analysis. A cross-tabulation analysis and binary logistic regression analysis were performed in this research to find the significant factors affecting kidney stones.</p> Results <p>The proportion of stone formers among adult attendees of RMCH was calculated to be 72.27% in males and 74.3% in females, respectively. The higher prevalence of kidney stones (75.53%) was found in people aged 41–70 years. Dietary practices, volume and kind of drinking water, drinking tube-well water clinical and biochemical characteristics were found to be associated with kidney stone status. The results also showed that the chance of having a kidney stone was higher in diabetic (74.35%), hypertensive (67.90%), and fatty liver (100%) individuals. Logistic regression analysis identified drinking tap water as an independent predictor of kidney stones.</p> Conclusions <p>This study highlights important demographic, dietary, clinical, and biochemical risk factors associated with kidney stone prevalence among adult attendees of RMCH in the Rajshahi region of Bangladesh. The findings may assist in developing targeted preventive strategies and public health interventions.</p>