The flexible ureteroscopy technique (RIRS) marks the beginning of a new era in urology. Today, antler stones can also be treated by RIRS. The preferred option for treating larger stones is percutaneous nephrolithotomy (PNL). However, there is a debate as to which is the first-line treatment option for larger stones, RIRS or PNL. Although many people are optimistic about the future of flexible scopes as a replacement for percutaneous nephrolithography in the treatment of large diameter kidney stones, there are also many people who believe that ureteral flexible scopes are premature in the treatment of kidney stones over 50 px in diameter, as this has not been recommended in any of the international guidelines for the treatment of stones. A recent study published this year by Dr. Zengin in Turkey provides some data to support this controversy by comparing the success and complication rates of PNL and RIRS procedures in the treatment of 2-3 cm diameter renal pelvic stones. The article retrospectively evaluated the medical records of 154 patients (74 PNL procedures and 80 RIRS procedures). Group 1 was patients who underwent PNL surgery and group 2 was patients who underwent RIRS surgery. At 1 month after surgery, the rates of complete stone removal were 95.5% and 80.6% in the PNL and RIRS groups, respectively, and the respective complication rates were 13.5% and 8.8%. The authors concluded that it is generally accepted in the medical community that percutaneous nephrolithoscopy is the best treatment for 2-75 px kidney stones. However, flexible scopes are comparable to percutaneous nephrolithoscopy in terms of stone removal rates, superior to PNL in terms of procedural complication rates, and will be the most likely alternative to percutaneous nephrolithoscopy in the treatment of larger stones in the future. Of course, further prospective randomized controlled trials are needed to confirm this conclusion.