In Alsace, urate lithiasis accounts for 32.7% of cases of lithiasis requiring hospitalisation. Fifty nine per cent of patients are hyperuricaemic, and only 10% have typical gout. 14.6% are hyperuricosuric but all have isoaciduria. A male disorder in 3/4 cases, it occurs above all after the age of 50. The relatively late onset, combined with marked obesity (mean weight 81.5 kg) is considered by the authors to be an argument proving the role of dietary excesses in the aetiology of this lithiasis. Excessive protein would seem to be the essential feature.