During a four year period, ending May 1987, 154 cases of symptomatic staghorn calculi have been treated by percutaneous nephrolithotomy. Of these patients, 86 % were discharged completely stone free with the remainder having fragments less than 5 mm in greatest diameter. More than one operative procedure during the same hospitalization was required in 24 % of patients and multiple percutaneous tracts were established in excess of 73 % of them. Significant complications occured in 16 % of patients and there was one death. Most complications can be generally be minimized by careful approach and manageable by interventional radiological means.