Objective To explore the application effect of prone split-leg position in percutaneous nephrolithotomy(PCNL).Methods A total of 79 patients with upper urinary tract stones who underwent surgery in our department from July 2021 to July 2022 were selected.According to the surgical position,the patients were divided into prone split-leg position group(n =35)and traditional prone position group(n =44).The two groups were compared regarding operation time,intraoperative blood loss,postoperative and preoperative hemoglobin changes,postoperative complications,one-stage stone free rate,and duration of hospitalization.Results The prone split-leg position group had significantly shorter operative time and higher one-stage stone free rate than those in the traditional prone position group[(69.6±20.7)min vs.(90.5±35.3)min,t =-3.280,P =0.002;97.1%(34/35)vs.79.5%(35/44),χ2 =3.984,P =0.037].There were 1 case of infection,3 cases of fever,and 1 case of bleeding in the prone split-leg position group,while 4 cases of postoperative fever and 2 cases of bleeding in the traditional prone position group,without significant difference in the incidence of complications between the two groups(χ2 =0.000,P =1.000).There were no statistical differences in intraoperative blood loss,number of working channel,hemoglobin changes,and duration of hospitalization(P>0.05).Conclusion Prone split-leg position PCNL can shorten the operation time,improve the one-stage stone free rate,and will not increase the risk of postoperative complications,with good safety and effectiveness.