Introduction Ultrasonography and radiography were evaluated regarding their ability to diagnose urolithiasis in rabbits. Material and methods A total of 120 rabbits with specific as well as unspecific signs were included in the study. Twenty healthy rabbits were used as controls. Specific clinical signs were defined as symptoms which were suggestive of calculi in the urinary tract or sludge in the urinary bladder. The ability to assess the amount of sediment within the urinary bladder as well as to identify and localise uroliths in the urinary tract were compared using both imaging techniques. Results Urinary sediment and urinary calculi could be detected in a considerable larger number of rabbits using ultrasonography compared to radiography. Furthermore, the extent of the urinary sediment could be evaluated more accurately by sonography. In some cases with large amounts of sediment detected sonographically, radiography failed to identify any sediment. Additionally, urinary bladder wall thickness increased significantly with increasing amounts of sediment. Uroliths could not consistently be detected by radiography, which was primarily true for renal calculi. Renal uroliths were predominantly identified in the rabbits included in this study. These rabbits were mainly presented with unspecific clinical signs, such as colic or inappetence, whereas rabbits with uroliths located in the urethra or large amounts of sediment in the urinary bladder mainly showed specific symptoms, like dysuria or stranguria. Conclusion Ultrasonography is superior to radiography not only in evaluating the amount of sediment but also in imaging smaller uroliths. Additionally, it is possible to further examine the urinary tract sonographically and detect secondary changes due to uroliths, such as hydronephrosis or dilated ureters. Moreover parenchymal changes of the kidneys and additional changes in other organs can be identified during sonographic examination. Therefore, ultrasonography is the imaging technique of choice, especially in cases with an unspecific history or financial constraints.