The aim of this study is to highlight the importance of percutaneous nephrolithotomy (PCNL) in the treatment of renal stones in elderly patients. We performed a ten-month retrospective study in 200 patients with kidney stones who underwent percutaneous nephrolithotomy during June 2016 - April 2017. The patients were divided in Group1 (178 patients under the age of 70 years old) and Group 2 (22 patients older than 70). The stones were mostly localized in the renal pelvis (142), inferior calyx (46) and ureteropelvic junction (4) and 28 cases with staghorn calculi. The renal stone was larger than 2 cm in 76%, less than 2 cm in 13%of the cases and 11% had multiple lithiasis. Intraoperative complications were: migrating fragments (22%), hemorrhage (12%), lesions of the renal pelvis and difficulties of percutaneous accessor dilatation (6%). The postoperative complications were: bleeding (20%), obstruction caused by stone fragments (22.5%), hydronephrosis (18%), fistula (13%). There were no significant correlations between intraoperative and postoperative complications and the two groups of patients (p > 0.05). The average length of stay in hospital after PCNL was 5.58 +/- 2.69 days SD. Stone-free rate was: 77.5%.PCNL is a safe and effective method used to treat large and complex stones that can be applied to both young and elderly patients. Intra and postoperative complications may occur in both age groups but this is not a decisive factor regarding therapeutic choice.