Abstract： Objective:To explore the efficacy and safety of percutaneous nephrolitotomy for upper urinary calculus in infants and toddlers.Methods:From January 2010 to December 2019, retrospective analysis of clinical data was performed for 114 children with upper urinary calculus undergoing percutaneous nephrolithotomy. They were divided into group 1 (F12-14) and group 2 (F16) according to different sizes of puncture channel. Then operative duration, tubeless ratio and 48 h post-operative stone free rate (SFR), hospitalization time, complications and hemoglobin decline were compared between two groups.Results:At 48 h post-operatively, the stone free rate was 91.8% in group 1 and 98.1% in group 2 ( P=0.278). The difference had no statistical significance. All 34 children with complete non-tubing were from group 1. The median operative duration was 41.5 min in group 1 and 90 min in group 2 ( P=0.413). There was no statistical significance. Postoperative hospital stay was 4 days in group 1 and 6 days in group 2 ( P=0.373). The difference had no statistical significance. The median postoperative decline of hemoglobin was 5 g/L in group 1 and 4.5 g/L in group 2 ( P=0.335). The inter-group difference had no statistical significance. There were 19 complicated cases (31.1%) in group 1 and 22 (41.6%) in group 2 ( P=0.25). The difference had no statistical significance. Conclusions:Percutanous nephrolithotomy is both efficacious and safe for upper urinary stones in infants and toddlers. Smaller puncture channels facilitate a faster recovery.