IntRoduCtIonPCNL or Percutaneous nephrolithotomy is a procedure by which a renal pelvic stone is extracted through a percutaneous tract [1]. PCNL is generally offered for staghorn calculi, stones greater than 2cm and those that are difficult to disintegrate by ESWL [2]. The advantage of PCNL over open procedure is its decreased cost, shorter operative time, decreased requirement of blood transfusion, decreased analgesic needs and an earlier return to activity [3]. However, PCNL is also associated with multiple complications associated with significant morbidity. These include haemorrhage, collecting system injuries, contiguous organ injuries, hypothermia, fluid overload, sepsis, and renal loss [4,5]. Since, these complications occur during the peri-anaesthetic period, anaesthesiologist should be prepared to anticipate, identify and rectify these complications. Here we present three cases of PCNL that were associated with peri-operative respiratory compromise.