Background: Kidney stones are a significant health concern in the United States, and their increasing prevalence is linked to increasing obesity rates. This study aimed to assess the trends in kidney stone prevalence among U.S. adults with obesity from 2007 to 2020 using National Health and Nutrition Examination Survey (NHANES) data. Materials and methods: This cross-sectional analysis used anonymized NHANES data from six cycles (2007–2020). Prevalences were estimated using NHANES sample weights; age-standardized prevalences were determined using 2020 census data. Survey-weighted multivariate logistic regression and linear regression models were used to assess risk factors and trends, respectively. Subgroup analyses were performed according to sex, race/ethnicity, and poverty-income ratio (PIR). Results: The overall age-standardized prevalence of kidney stones increased from 9.4% (2007–2008) to 10.2% (2017–2020). The prevalence among individuals with obesity significantly increased from 11.0% to 12.5% ( P for trend = 0.035). The prevalence of kidney stones in females with obesity significantly increased from 8.8% to 11.5% ( P for trend = 0.042), whereas males with obesity showed a slight increase (13.4% to 14.0%). Racial/ethnic disparities were evident among those with obesity: non-Hispanic Whites showed a modest increase (12.4% to 14.2%), Hispanics exhibited a notable increase (7.5% to 10.9%; P for trend = 0.017), and non-Hispanic Blacks had a stable prevalence that increased slightly (5.9% to 6.8%; P for trend = 0.304). The prevalence increased (10.2% to 12.9%; P for trend = 0.051) among individuals with obesity and high PIRs and decreased (12.8% to 11.4%) among those with low PIRs. Conclusions: This study highlights an upward trend in the prevalence of kidney stones among U.S. adults with obesity, from 2007 to 2020. Our findings emphasize the need for targeted public health strategies to address this issue, especially among populations at higher risk due to obesity and socioeconomic factors.

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