Stone masonry is the predominant construction method in Nepal's high-altitude regions, yet buildings frequently suffer from defects that compromise structural integrity and occupant safety. This study investigates the common defects, underlying causes, and impacts in stone masonry residential buildings through a case study of Jumla District, Nepal. Using a qualitative methodology incorporating Focus Group Discussions (FGDs) with 15 stakeholders and field observations of 5 buildings, the research identifies recurrent defects including cracking, uneven settlement, mud plaster fall-down, weathering and deterioration, discoloration/erosion, and poor drainage. Thematic analysis reveals that these defects primarily originate from poor-quality materials, improper construction practices, inadequate foundation work, and harsh environmental conditions. The impacts range from structural instability and aesthetic degradation to increased maintenance costs. A notable finding is the divergence in perspectives between technical stakeholders (engineers) who emphasize systemic design and material issues, and non-technical stakeholders (owners, workers) who focus on observable symptoms and workmanship problems. The study contributes empirical evidence on construction quality challenges in high-altitude, resource-constrained environments and provides practical insights for improving stone masonry construction practices. Recommendations include enhancing workforce skills, improving foundation construction, strengthening material quality control, and implementing regular maintenance programs.