n this procedure by small 1 cm incision in flank under anesthesia & under vision of nephroscope – any hard or big stone can be fragmented by pneumatic or Holmium laser Lithotripsy & removed. Usual operative time is 30 to 60 minutes & usually patient dose not requires blood transfusion. Patient needs 48 hrs. hospitalization & 1 or 2 days more rest then patient can resume his duty. Usually by procedure 99% of big renal stone can be treated successfully. We have successfully performed more than 10000 PCNL includes single, multiple, bilateral, staghorn & complicated renal stones.