Percutaneous nephrolithotomy is a minimally invasive procedure done in renal calculus patients with stone size more than 2 cm.In this study we have observed the various outcomes especially stone clearance and need for ancillary procedures in upper, middle, lower calyceal punctures.In our study 216 cases who underwent Percutaneous nephrolithotomy in our institute from 2011to 2018 were retrospectively analysed. The calyceal approach, number of punctures, residual stones are noted. Residual stones are seen in 22 cases of staghorn and multiple calyceal stones. These patients were subject to Extracorporeal shockwave lithotripsy (12)/relook Percutaneous nephrolithotomy (7) /conservative management(3).