Background: ultrasound guided percutaneous nephrostomy was reported in various positions to different indications. Objectives: this study was conducted to determine the feasibility of Percutaneous Nephrostomy (PCN) in lateral position. Patients and methods: this study was conducted during the period from March 2018 to November 2018. Fifty patients with urinary tract obstruction who were candidate for percutaneous nephrostomy at El-Hussein and Bab El-sharia hospitals were enrolled in the present study. Results: out of 50 patients who underwent percutaneous nephrostomy in lateral position (56%) were males, 44% were females. Success rate for fixation of PCN was 90%. Total number of patients with marked hydro nephrosis before the procedure represented 58% of total patients and 42% with moderate hydro nephrosis. Complication of technique : no complication represented 80% ,minor complications were 20%,9% showed transient hematuria, single patient with pain 2.2%, 4.4% showed catheter related complications, 4.4% showed Inflammation of skin at the side of the wound. Cause of obstruction, pregnant females were 10%, PUJ causes were 18%, ureteric causes were 46%, urinary bladder mass was 14%, single case was emphysematous pyelonephritis, others were10%. Conclusion: ultrasound guided percutaneous nephrostomy in lateral position is feasible and equal to standard technique but recommend PCN in lateral position in, pregnant female, obese patients, ascetic patients and patient with special difficulties in breathing.