Urolithiasis is becoming a prevalent disease in young adults where instances are noted to be affected by dietary habits, lifestyle changes, and metabolic disorders. Studies in recent years have shown that serum levels of uric acid might be important in the development of stones, the significance of this link with the development of stone disease is yet to be determined. This study set out to find out the relation between serum uric acid levels and urolithiasis risk among young adults and put it against dietary habits and physical activity. A case-control study among 100 respondents aged 18 to 35 years old was conducted at Central Park Medical College from May 2024 to September 2024. The cases were 50 respondents with urolithiasis and 50 respondents without urolithiasis formed the control group. They found serum uric acid levels of 7.2 ± 1.5 mg/dL in cases while those for the controls averaged 5.3 ± 1.2 mg/dL, p < 0.001. Dietary factors such as consumption of purine-containing foods, sugary drinks, and low physical activity were also associated with urolithiasis. Multivariate analysis indicated serum uric acid as the most important independent risk factor (OR: 1.885, 95% CI: 1.35 – 2.45, p < 0.001). The results suggest that serum uric acid can be offered to help combat urolithiasis within young adults as a risk biomarker and consequently provide new directions for urolithiasis preventive approaches. More longitudinal studies are required to demonstrate the cause-and-effect relationship and examine treatment measures.