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Urolithiasis is the process of forming a kidney stone or lower down in the urinary tract. In Ayurvedic medicine this disease is identified as Ashmari. It is derived from the "Ashman" Sanskrit word which literally means a structure resembling stone. Mutrashmari is one of the most common and distressing maladies among urinary disorders. Mutrashmari (Urolithiasis) is a very common global problem, disturbing mankind since long time. Ashmari has been mentioned in all ancient texts of Ayurveda but Acharya Sushruta has described it elaborately in Sushruta Samhita along with its medicinal as well as surgical management. Ashmari is one of the major reasons of abdominal pain in present time. Etiology and pathogenesis of renal stone is not very clear. Risk factors for developing kidney stone are familial, obesity (High BMI) , not drinking enough water, eating a diet that's high in protein, sodium (salt) and sugar. The four most common types of renal stones are calcium, uric acid, struvite and cystine. Calcium stones are the most common type of kidney stones.Treatment of renal calculi in modern science is mainly surgery and almost none oral modern medicine available for this purpose. Available management of renal calculi like extracorporeal shock wave lithotripsy, cystolithotomy etc. fail to prevent the recurrences and have many side effects such as sepsis, strictures, splenic rupture, renal hematoma etc. Ayurvedic texts have mentioned Mutra- virechaniya (diuretic) and AshmarighnaDravya (lithotriptic) which is very beneficial for urolithiasis. Acharya Sushruta had also mentioned perineal approach to remove the stone from the bladder when stones are too large and not responding to medicinal treatment. In modern medicine there are few drugs such as Allopurinol, Magnesium oxide, Hydrochlorothiazide and Alkaline phosphates used to treat the kidney stone. There are many side effects by these drugs. For example, thiazides, low dose of this diuretic causes potassium loss, allopurinol can cause skin rashes, leucopenia and phosphate drug can cause diarrhea. In comparison, Ayurvedic system is better way for treatment of Ashmari (Urolithiasis). In this book description of "Mootrasmari" and its modern parlance urolithiasis is given in a detailed manner so as to be beneficial to Ayurveda students and to Ayurveda medical practitioners in particular.