This retrospective study was conducted to determine the prevalence of urinary calculi in the indigenous population of Saudi Arabia and compare it with expatriates of different nationalities working in Saudi Arabia with emphasis on the anatomic location of the calculi and the role of ultrasound in the detection and management. The study included 5371 patients (both sexes, mean age 36.6 years) examined by us from September 2004 to February 2008. The patients hailed from 30 countries, which included Bangladesh (42.3%), Pakistan (18.3%), Yemen (17.5%), India (6.5%), Sudan (3.4%), Saudi Arabia (2.8%), Egypt (2.3%) and Eritrea (1.7%). All patients were referred for abdominal/renal ultrasonography. Urinary calculi were detected in 1029 patients. The distribution of calculi was as follows: Renal 73.3%, pelviureteric junction 2.3%, proximal, middle and distal thirds of the ureter 13%, vesicouretic junction 9.8%, vesical 1.1% and urethral 0.5%. The prevalence of urinary calculi according to ethnic origin in descending order of frequency was Egyptians (29.5%), Pakistani (24.9%), Indian (23.3%),Yemeni (20.5%), Sudanese (17.6%), Bangladeshi (16.2%), Eritrean (15.4%) and Saudi Arabian (7.4%). Urinary calculi were found in 19.1% of the studied population. Approximately three-quarters of the calculi were located within the kidney. The nationalities with the highest prevalences were Egyptian, Pakistani and Indian.