Abstract: ob＜x＞jective To compare and analyze curative effect of flexible ureteroscopy lithotripsy (FURL) vs. percutaneous nephrolithotomy( PCNL) for renal calculi of 2 - 3 cm. Methods The clinical data of 298 renal calculus patients in Affiliated Hospital of Xuzhou Medical University from July 2017 to May 2020 were retrospectively analyzed. According to different operative methods，146 patients were divided into the Observation group (FURL) and the other into Control group (PCNL). The stone load, stone location, numbers of stones, body mass index(BMI), counts of hemoglobin(Hb), white blood cells(WBC) and creatinine(Cr) before and after surgery, The operation time, intraoperative blood loss, postoperative complications, postoperative hospitol stay, all-in cost and stone clearance rate were recorded. Results The intraoperative blood loss, postoperative hospitol stay and postoperative complications in Observation group were significantly reduced as compared with those in Control group（P<0.05）.The operation time and hemoglobin at 24 h after surgery in Observation group were significantly higher than those in Control group（P<0.05）.The stone clearance rate in lower calyx in Observation group were lower than those in Control group（P<0.05）.Conclusions Both flexible ureteroscopy lithotripsy and percutaneous nephrolithotomy have a good curative effect in the treatment of upper and middle calyceal calculi of 2-3 cm. However, the former can reduce intraoperative blood loss and postoperative complications, it is more in line with the conception of enhanced recovery after surgery and worthy of popularization and application