Kidney transplantation is the main treatment for uremia, and stones in the transplanted kidney after surgery are a rare complication. Stones may block the ureter leading to hydronephrosis and impair kidney function. The formation of stones may be related to hyperuricemia, abnormal calcium metabolism, ureteral stenosis and urinary tract infection. Treatment of transplanted kidney stones is similar to isolated kidney stones, but the patient’s condition is more complex and the core of treatment is to protect kidney function. The choice of treatment is similar to that for patients with common stones, but transplanted kidney stones have their own characteristics. If the stone blocks the ureter causing anuria, an emergency nephrostomy or surgery is required to remove the stone. Small uric acid stones can be treated by hydration combined with citrate preparations or sodium bicarbonate lithotripsy. Minimally invasive surgery is preferred for the treatment of large stones. Ureteroscopic stone extraction has a low success rate and cannot be placed into the ureteroscope due to the angle of the opening. Percutaneous nephrolithotomy is the more commonly used minimally invasive surgical method. Try to choose a site with relatively few blood vessels to make a hole to reduce bleeding and injury. Special attention should be paid to infection and incision healing as patients are often on oral anti-rejection medications, including hormones, and have a weak resistance.