Semi-arid Karha basin from Deccan Volcanic Province, India was investigated for inter-annual variability of urolithiasis epidemic. The number of reported urolith patient, weather station data and groundwater quality results was used to assess impact of geoenvironment on urolithiasis. Data of 7081 urolith patient were processed for epidemiological study. Gender class, age group, year-wise cases and urolith type were studied in epidemiology. Rainfall, temperature, pan evaporation and sunshine hours were used to correlate urolithiasis. Further, average values of groundwater parameters were correlated with the number of urolith episodes. A total of 52 urolith samples were collected from hospitals and analysed using FTIR technique to identify dominant urolith type in study area. Result shows that male population is more prone, age group of 20-40 is more susceptible and calcium oxalate uroliths are dominant in study area. Year-wise distribution revealed that there is steady increase in urolithiasis with inflation in drought years. In climatic parameters, hot days are significantly correlated with urolithiasis. In groundwater quality, EC, Na and F are convincingly correlated with urolith patients, which concludes the strong relation between geo-environment and urolithiasis.