This prospective study aimed to evaluate the current status of percutaneous nephrolithotomy (PNL) at the urology department Kasr-El-Aini hospital, Cairo University in terms of efficacy, safety, operative procedure and intraoperative and early postoperative complications. Procedures were performed on 71 adult patients during the period from February 2012 to August 2012. Perioperative assessment and investigations were done. Intraoperative complications occurred in 18 patients (25.4%) in the form of bleeding (16.9%), perforation of collecting system (5.6%) and extravasation in 3 patients (4.2%). Sepsis occurred in 5 patient (7%), postoperative fever in 43 patients (60.6%), 17 patients (23.9%) of these had a fever >38.5ºC. postoperative hematuria occurred in 8 patients (11.3%). Renal insufficiency, large stone size, long operation time and multiple access tracts all these factors increased the risk of intraoperative complications of percutaneous nephrolithotomy (PNL) (P value 0<0.05). Complete stone clearance rate was recorded in 46 patients (64.8%) and increased to (73.3%) after second look PNL in 6 patients (8.5%). In 19 patients (26.8%) there were residual stones that were treated by SWL. In this study, we also found that there is no correlation between the risk of complications and the experience of the surgeon (P value >0.05). The mean operative time was (2.3) ±0.8 hours. The mean hospital stay was 3.3 days with no complications, and 8.9 days for patients with complications.