<![CDATA[Introduction: Urolithiasis is common, and reviews suggest benefits of N. sativa, although evidence remains limited. This review evaluated efficacy and safety of N. sativa-based interventions in adults with urinary stones. Method: The protocol was registered in PROSPERO (CRD420261470368). PubMed, Scopus, ScienceDirect, and Google Scholar were searched to 3 August 2026. Randomized controlled trials of N. sativa-based interventions were eligible, with risk of bias assessed using the Cochrane Risk of Bias 2 tool. Result: Four trials involving 262 participants were included. Compared with tamsulosin, N. sativa-containing interventions increased complete stone passage (RR = 2.12, 95% CI: 1.31–3.43; p = 0.002; I² = 0%). Compared with control or placebo, N. sativa-based interventions increased stone passage (RR = 2.47, 95% CI: 1.50–4.08; p = 0.0004; I² = 0%). Stone size reduction favored N. sativa-based interventions (MD = −2.32 mm, 95% CI: −3.07 to −1.57; p < 0.00001; I² = 0%). Each meta-analysis included only two trials. One study had low risk of bias and three had some concerns. Safety data were limited. Conclusion: N. sativa-based interventions may improve stone passage and reduce stone size, but evidence is limited by few trials, heterogeneous interventions, and safety reporting. Larger trials using standardized preparations are needed.]]>
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