Background and Aims: Cholelithiasis is a common upper gastrointestinal tract disorder in the Kingdom of Saudi Arabia. Analyses of risk factors for gallstone formation may explain the need for lifestyle modifications. Therefore, our aim was to identify sex- and age-related differences in the prevalence and risk factors for gallstones among Saudi individuals in the city of Al-Ahsa. Methods: The medical records of patients, ≥1 year of age, with a radiologically confirmed diagnosis of gallstones, between 2014 through 2016, were retrieved and relevant demographic and clinical data extracted. Risk factors for cholelithiasis for all age groups were identified. Results: A total of 618 patients had radiologically confirmed gallstones over the 3-year period of observation. The prevalence was higher among females than males (73% versus 27%, respectively) in all age groups. In the paediatric group, the prevalence of gallstones was higher among girls with obesity and those with sickle cell disorders. Advanced age, a higher body mass index, high low-density lipoproteins, triglycerides, and cholesterol were independently associated with cholelithiasis in both gender of all age groups. Hepatitis B and C were not found to be risk factors for cholelithiasis. Conclusions: Older age, female sex, a high body mass index, and hyperlipidaemia are major risk factors for gall stones formation among all age groups. Haemolytic anaemia, namely sickle cell disease, is a prevalent risk factor in paediatric population.