The Federal State Organization Research Institute of Urology in 115 patients with bilateral staghorn nephrolithiasis in the period from 2009 to 2011 compared three methods of surgical treatment: percutaneous nephrolitholapaxy, combined treatment ( percutaneous nephrolitholapaxy and SWL ) and open surgery – efficacy stone removal, the rate of complications and length of hospitalization. Before surgery all patients underwent a standard examination and performed the above methods of surgical intervention. Our study showed that the percutaneous nephrolitholapaxy was a high efficiency to get rid of stones with minimal timing of treatment and the rate of complications. With this type of surgery most frequently encountered the following complications: acute exacerbation of chronic pyelonephritis (15.4 % cases), postoperative bleeding (12.3%), intraoperative complications (9,2 ). In the combined treatment was good enough results to remove the stones, but it is necessary to carry out treatment in 2 stages, which increases total time of hospital treatment. Along with the same complications that have occurred during percutaneous operations in the combined treatment is sufficiently high probability of "stone path" (25%). When open surgery is also able to achieve a high success remove staghorn, but the indicators of treatment time and number of complications were the worst. The most frequent: exacerbation of chronic renal failure in 38.5 % of patients, intra-and postoperative bleeding in 34.6 % of patients, other complications in 19.2 % of cases.