Abstract: Objective: To compare the efficacy and incidence of complications between percutaneous nephrolithotomy(PCNL) and flexible ureteroscope lithtripsy(FURS) in the treatment the renal calculus.Methods: One hundred and seventy-eight patients with renal calculus were divided into the PCNL group(94 cases) and FURS group(84 cases).According to the diameter of stone,the PCNL group were subdivided into the renal stone more than 20 mm group(51 cases) and renal stone less than or equal to 20 mm group(43 cases),and the FURS group were subdivided into the renal stone more than 20 mm group(43 cases) and renal stone less than or equal to 20 mm group(41 cases).The general data,operating time,amount of bleeding,postoperative infection,postoperative complication,incidence of two-stage operation or ESWL and clearance stone rate at postoperative 1 week and 1 mouth between two groups were compared.Results: All operations were successful.The differences of the age,stone diameter and location between two groups were not statistically significant(P>0.05).The time of operation and crushing stone,and postoperative infection rate in PCNL group were shorter than those in FURS group(P<0.01 and P<0.05).The postoperative hospitalization stay in PCNL group was longer than that in FURS group(P<0.01).The clearance stone rate in PCNL group after 1 week of operation was higher than that in FURS group(P<0.05).In those patients with the stone diameter less than 20 mm,the differences of the clearance stone rate at postoperative one month and occurrence of the second stage operation or ESWL between PCNL and FURS group were not statistically significant(P>0.05).In those patients with the stone diameter more than or equal to 20 mm,the clearance stone rate at postoperative one month in PCNL group was higher than that in FURS group(P<0.05),and the occurrence of the second stage operation or ESWL in PCNL was lower than that in FURS group(P<0.05).Conclusions: The PCNL and FURS are effective methods in the treatment of renal calculus.The PCNL is high clearance stone rate and low infection rate,especially for the patients with the stone diameter more than 20 mm.The FURS is minimally invasive and quick recovery,especially for the patients with the stone diameter less than 20 mm.The treatment of patients with multiple renal calculus and staghorn calculus with PCNL combined with FURS can improve the clinical efficacy.