Purpose: comparison the efficacy and safety of percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) in treatment of renal stones. Patients and Methods: Records of patients who underwent surgery for renal stone were retrospectively reviewed, for two years from the beginning of 2017 till the end of 2019. Patients who had renal stones between 10 -20 Millimeter and located in different renal calices were included, patients who underwent percutaneous nephron-lithotomy PNL and retrograde intra-renal surgery RIRS were defined as Group I and Group II, respectively. Patient criteria (age, sex, BMI); the stone characteristics; time of procedure, fluoroscopy and hospitalization; stone-free and complications (bleeding, pain, infection, visceral injury, conversion to open surgery, and need for blood transfusion) were evaluated between the treatment groups. Result: There were no significant differences in terms of age, gender, BMI, laterality, number of stones, Hounsfield units and surface area characteristics of the stone between the PNL (n 25) and RIRS (n = 35) groups (P = .