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Objectives This study aimed to investigate the knowledge, attitudes and practices (KAP) of patients with urinary calculi in China, where prior KAP research on this condition is lacking.Design A cross-sectional study was conducted.Setting The study was carried out in Jiangsu Province between August and September 2024.Participants Patients diagnosed with urinary calculi were included, with 440 valid questionnaires analysed (65.9% male).Primary and secondary outcome measures Primary outcomes were KAP scores (knowledge: 0–30, attitude: 6–30, practice: 7–35). Secondary outcomes included structural equation modelling (SEM) analysing relationships between KAP domains.Results Mean scores were 10.63±3.73 (knowledge), 22.37±4.16 (attitude) and 22.40±5.36 (practice). SEM revealed direct effects of knowledge on attitude (β=0.652, p<0.001) and practice (β=0.375, p<0.001), and attitude on practice (β=0.432, p<0.001). Knowledge also indirectly influenced practice via attitude (β=0.281, p<0.001).Conclusions Patients with urinary calculi tended to demonstrate limited knowledge but moderate attitudes and practices towards their condition. These findings suggest potential gaps in patient understanding and indicate that educational approaches may play a role in supporting urinary calculi management.