Introduction: PCNL is the procedure of choice for managing patients with renal stones.Aim of the work: To evaluate the safety and efficacy of PCNL in patients with and without a history of previous renal surgery. Patient and method: This is a prospective study carried out on 40 patients classified into two groups (group A: fresh cases and group B: recurrent ones). All patients were evaluated preoperatively by U/S, KUB, IVU, full lab investigations. Result: The mean age of our patients was 41.9 ± 11.1years, 31 males and 9 females. Although the operative time, the need for blood transfusion, postoperative hospital stay, and residual stones were found to be more in group B than group A, this was not found to be statistically significant. Moreover, the incidence of complications was found to be equivalent in both groups. Conclusion: PCNL is an equally safe and effective procedure for managing patients with renal stone in fresh and recurrent cases.