With the development of the ultrasonically guided punction of the kidney it has become possible nowadays to achieve direct access to the kidney without much difficulty. The puncture tract can be widened and used for the entrance of the so-called nephroscope, which enables the sitting and extraction of renal calculi, which are not able to drain away by themselves. The calculi are removed through the shaft by small forceps. Larger calculi are chiefly removed by means of ultrasonic probes or electro-hydraulic shock waves. This method of percutaneous lithotripsy or litholapaxy is also suitable for the extraction of calculi from kidneys with impaired drainage. Since the procedure can be carried out in a large proportion of patients with local anaesthesia, there are hardly any contraindications--except in cases of complete staghorn calculi. In contrast to the extracorporeal shock wave lithotripsy little apparatus is needed and it is not too expensive; therefore, it is also suitable for smaller hospitals and departments. The percutaneous lithotripsy represents a safe method of renal calculus extraction with little stress for the patients.