Objective To analyze the efficacy of percutaneous nephrolithotomy (PCNL)combined with ureteroscopy in treatment of renal staghorn calculi. Methods The data of 126 patients with renal staghorn calculi were retrospectively analyzed in the department of urinary surgery of our hospital. All patients were treated with PCNL combined with ureteroscopy. The related data of preoperative, intraoperative and postoperative were recorded and analyzed. Mean-while, 89 patient with renal staghorn calculi treated by PCNL were selected as control group. The related parameters between two groups were compared. Results Compared with control group,the operation time, amount of bleeding and complication rate of PCNL combined with ureteroscopy group were lower(P<0.05), the stone clearance rate of PCNL combined with ureteroscopy group was higher(P<0.05). Among of PCNL combined with ureteroscopy group,27 patients suffered from fever after surgery and 1 patient had hemorrhage. No renal collection system tear or perforation,damaged pleura, bowel and major vessel occurred. 15 patients had residual stones and were treated by two-stage operation. 48 cases were followed up from postoperative 6-36 months and there wasn't stone recurrence. Conclusion PCNL com-bined with ureteroscopy guided by ultrasound is a good choice in treatment of renal staghorn calculi.