Abstract: ObjectiveTo compare the effects of the upper，middle and lower kidney calyx route in the treatment of kidney and upper ureteral calculi through percutaneous nephrolithotomy( PCNL) . Methods: Three hundred and ninty-two cases with kidney and upper ureteral calculi were treated with PCNL， and divided into the upper renal calyx calculi or pelvic stones， lower renal calyx calculi， antler shape stone and upper ureteral calculi( complicating with or without kidney stone) group.The first period calculi completely clearance and puncture success rate，and operation time of the upper，middle and lower kidney calyx route were compared.Results: The first period calculi completely clearance rate and operation time of the upper renal calyx calculi or pelvic stones group through the upper and middle and lower kidney calyx route were 89.4% ＆ 95.1% and( 77.76 5.04) ＆( 81.09 4.14) minutes， respectively.Their differences had statistical or no statistical significance( P 0.05 and P 0.01) .The first period calculi completely clearance rate of the lower renal calyx calculi group through the upper and middle and lower kidney calyx route were 90.9% and 80.0%， respectively，which had no statistical significance( P = 0.572) ， the operation time were( 75.32 9.23) and( 84.5 15.27) minutes， respectively，which had statistical significance( P 0.05) .The first period calculi completely clearance rate and operation time of the antler shape stone group through the upper and middle and lower kidney calyx route were 88.2% ＆ 72.3% and( 118.69 3.28) ＆( 141.08 4.78)minutes， respectively.Their differences had statistical significance ( P 0.05 and P 0.01 ) .The first period calculi completely clearance rate and operation time of the upper ureteral calculi group through the upper and middle and lower kidney calyx route were89.7% ＆ 64.0% and( 98.98 6.12) ＆( 115.56 6.98) minutes， respectively.Their differences had statistical significance( P 0.05 and P 0.01) .The puncture success rates of all cases are 100%. Conclusions: The calculi clearance rates of the antler shape stone and upper ureteral calculi through the upper kidney calyx route is higher， and its operation time is shorter.