Objectives: Recent epidemiologic studies have shown that incidence of urolithiasis is increasing and these stone formers are at increased risk for end stage kidney disease (ESKD). However, most of the studies are population-based historical cohort studies with the use of only diagnostic codes. We tried to prove that urolithiasis is a highly heterogenous conditions potentially linked to different clinical outcomes according to stone compositions. Methods: We performed a single center retrospective study of symptomatic stone formers with known stone compositions (n=758). Baseline characteristics and prevalence of diverse comorbid conditions and long-term outcome were compared according to different subtypes of stones. Results: Mean age was 60.9±14.2yrs with male predominance (64.5%). Calcium oxalate stone was the most common type followed by ammonium stone, uric acid stones. Proportion of elderly (71-100yrs), prevalence of diabetes, hypertension, ischemic heart disease, heart failure and chronic kidney disease (CKD) were significantly higher in uric acid stone formers. Acute kidney injury defined as serum creatinine increase of more than 0.3mg/dL compared with baseline creatinine was accompanied in 10.4% of patients and the incidence of AKI was also significantly higher in uric acid stone formers. During the median follow up of 10yrs, mortality was observed in 10 patients (1.32%) of patients with the highest rate in uric acid stone formers. Conclusions: These data suggest that clinical characteristics and short and long-term kidney outcomes might be significantly different according to subtypes of stones. Better understanding of epidemiology, risk factors and outcomes of kidney stone disease are needed.