Background: Urolithiasis refers to the formation of calculi as a result of a disruption in the equilibrium between salt solubility and precipitation in the urinary system. Computed tomography is considered to be extremely sensitive diagnostic test for its detection due to development in technology. The goal of this study was to find out the accuracy of ultrasound for detection of urinary tract stones as compared to CT KUB. Objective: The purpose of this study is to evaluate the sensitivity and specificity of ultrasound with the reference of CT KUB for the diagnosis of urinary tract stones. Material and Method: The cross-sectional study was conducted from January 13, 2022 to May 13, 2022 in the Department of Radiology, Gondal Medical Complex Gujranwala, in 78 patients who underwent simple CT KUB after USG with suspected urinary stones. Ultrasound and CT findings were compared based on age, gender, clinical appearance, number of stones, and location. All data was collected using a self-made questionnaire. I analyzed the data using SPSS version 26. USG specificity, sensitivity, positive predictive value, and negative predictive value were evaluated using CT as a reference standard. Results: Among the 78 patients, 56.4 % (n=44) were male and 43.6 % (n=34) were female. The average age of the patients was 41.5430 years. Urolithiasis was discovered in 80.76 % of the patients (n=63) who had CT KUB. Trans-abdominal ultrasound sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy in urolithiasis were calculated to be 68.3 %, 66.7 %, 89.6 %, 33.33 %, and 67.95 %, respectively. Conclusion: Trans-abdominal ultrasonography has a satisfactory diagnostic accuracy for urolithiasis since a range of parameters such as operator reliance, patient compliance, and stone size or location determines its sensitivity. When a CT scan is unavailable or contraindicated, it may be utilized as an alternative.