The continuous development and wide application of percutaneous nephrolithotomy has brought a boon to patients with urinary stones. It is less invasive and quicker to recover, and even complicated kidney stones and some intractable kidney stones that previously required open surgery can now be well treated by minimally invasive percutaneous nephrolithotomy. However, it is worth paying attention to the high recurrence rate of urinary stones after treatment, with an average of more than 50% of patients having to undergo treatment again every 10 years due to stone recurrence. Therefore, it is especially important to prevent recurrence of stones in patients treated with percutaneous nephrolithotomy. The simplest, most effective and economical way to prevent kidney stones is to drink plenty of water. Patients with kidney stones should maintain a daily urine volume of more than 2,000 ml. Maintaining dilute urine prevents the formation of urinary crystals, promotes the discharge of small stones, and slows the growth of stones, and has a preventive and curative effect on all components of urinary stones. Urinary tract stones have a variety of components, commonly consisting of a mixture of calcium salt crystals. According to the composition of the patient’s postoperative stones, the development of a targeted individualized dietary modification and drug prevention program is the key to preventing stone recurrence after percutaneous nephrolithotomy. For example, patients with calcium oxalate stones should have a low calcium and low oxalic acid diet, eat less spinach, celery, peanuts and beets with high oxalic acid content, and avoid excessive consumption of coffee, black tea, apple juice and Coca-Cola. People with uric acid stones should avoid high purine foods, such as animal offal and seafood, etc. They can take oral potassium citrate and sodium bicarbonate to alkalize the urine and keep the urine pH at 6.5, and apply allopurinol to reduce blood uric acid. Those with infected stones should actively treat and prevent urinary tract infections and acidify the urine. Those with cystine stones should avoid excessive consumption of foods rich in methionine (soy, wheat, fish, meat and mushrooms). In addition to the application of potassium citrate to alkalize the urine, oral captopril is also useful in preventing the formation of cystine stones. Percutaneous nephrolithotomy is mainly used for complex kidney stones such as those with a diameter of 2 cm or more, multiple or cast stones. For those who have frequent recurrence of stones after surgical treatment and still have residual stones in the kidney, further systemic metabolic evaluation should be performed to find the etiology. In the presence of hyperparathyroidism, surgical removal of adenoma or hyperplastic tissue is feasible, and in the presence of urinary tract obstruction or urinary tract malformation, timely correction should be performed.