Objective: To determine the incidence of various metabolic abnormalities in pediatric cases of renal calculi. Place and Duration of Study: This was a cross-sectional study conducted at Ghurki Trust Teaching Hospital, Lahore from November 2022 to April 2023. MATERIAL AND METHODS: This research employed a cross-sectional study design. The sample size of 125 patients was calculated. This study included pediatric patients ranging from 1 to 18 years old who have been clinically diagnosed with kidney stones on ultrasound or non-contrast CT scans. Informed consent from parents or legal guardians is a requisite for participation. Cases without a confirmed diagnosis of kidney stones, verified through imaging studies, are excluded. Clinical and demographic data were collected using standardized forms. Information included age, gender, medical history, dietary habits, and family history of kidney stones. Statistical analyses were conducted using SPSS, comparing the prevalence of metabolic abnormalities among pediatric patients with kidney stones. RESULTS: There were 55 male patients, constituting 44% of the total, and 70 female patients, representing 56% of the total. There were 90 cases with a family history of kidney stones, constituting 72% of the total, while 35 cases had no family history, accounting for 28% of the total. Study indicates that 82.4% of the studied population exhibited the presence of metabolic abnormalities, There were 65 cases of hypercalciuria, making up 52% of the total. Hyperoxaluria was observed in 50 cases, constituting 40% of the total. Additionally, hyperuricosuria was present in 40 cases, representing 32% of the total. Hypocitraturia was identified in 30 cases, accounting for 24% of the total. Hypomagnesuria was observed in 20 cases, contributing to 16% of the total. CONCLUSION: In conclusion, our study highlights a significant prevalence of metabolic abnormalities, with 82.4% of the pediatric population exhibiting these conditions. The prominence of hypercalciuria underscores the importance of targeted interventions for effective management and prevention of recurrent kidney stones in children. These findings contribute valuable insights for clinicians in devising tailored strategies for improved patient care.