Objective: To investigate the effect of percutaneous nephrolithotomy (PCNL) on the treatment of kidney stones under general anesthesia and spinal anesthesia. Methods: From May 2017 to December 2017, 58 patients underwent standard percutaneous nephrolithotomy. The patients were randomly divided into 2 groups. The first group was general anesthesia, and the second group was in the PCNL group under spinal anesthesia. The basic data, intraoperative, and postoperative parameters of the 2 groups were compared. Results: There were no significant differences in gender, age, stone size, body weight, anesthesia grade, operation time, postoperative hemoglobin decline, postoperative fever incidence, VAS score on the second postoperative day, mean hospital stay, and stone clearance rate (P>0.05). The incidence of hypotension in the general anesthesia group was significantly higher than that in the spinal anesthesia group, and the VAS score on the first day after the surgery in the general anesthesia group was significantly higher than the spinal anesthesia group (6.47±1.39 vs 4.51±0.81, P<0.05). Conclusion: PCNL is safe and effective in the treatment of renal stones with general anesthesia and spinal anesthesia. PCNL treatment of kidney stones under spinal anesthesia has lower incidence of hypotension, less postoperative pain and shorter hospital stay.