Prostatic calculi are common finding in radiographic examination, however, the true incidence and the clinical significance are not clearly known. We investigated the prevalence of prostatic calculi and the relationship between prostatic calcification and urolithiasis. From a database, 305 consecutive subjects older than 30 years of age who had undergone regular health checks in our hospital from January 2007 to July 2009 were enrolled in this study. Prostatic calculi and urinary stones were confirmed by non-enhanced CT. According to the presence of prostatic calculi, they were divided into two groups and the relationship with urolithiasis was determined using statistical analysis. Among 305 male subjects, prostatic calculi were found in 97 (31.9%), which revealed a linear trend with aging (r=0.928, p=0.023), while asymptomatic upper urinary tract stones were found in 45 subjects (14.9%). A significant difference was observed in mean age (p<0.001), however, no difference was observed in prevalence of diabetes mellitus (DM), hypertension (HT), and body mass index (BMI). In the prostatic calculi group, 24 (24.7%) subjects had previously unknown urolithiasis, while only 21 subjects (10.1%) in the non-prostatic calculi group had urinary stones. The prevalence of urolithiasis was significantly higher in men with prostatic calcification than in those without prostatic calcification (OR=2.92, 95% CI: 1.53-5.58, p=0.001). No significant differences in serum chemistry were observed between the two groups. Among the 45 patients with urolithiasis, no significant differences were observed in the mean stone size according to the presence of prostatic calcification. Our data showed that prostatic calcification was prevalent up to approximately 31.9% and was frequently combined with upper urinary tract stones. These results indicate that evaluation for urolithiasis might be needed in patients with incidentally detected prostatic calcification.