Cast stones mean that the tube inside the kidney is filled with stones, similar to the meaning of casting a mold hence the name. Some cast stones resemble antlers, therefore, cast stones are also called antler stones. Most cast stones are associated with urinary tract infections, where bacteria can produce urease to break down the urea in the urine and form infected stones, which grow faster. Cast stones formed by bacterial infection are often accompanied by recurrent urinary tract infections, which can lead to kidney function impairment even if they do not lead to hydronephrosis. Not all cast stones are infected stones; diseases such as hyperparathyroidism and cystinuria can also form cast stones. Deerstalker type stones are complex stones, which are difficult and risky to operate. Before surgery, it is necessary to prepare adequately, control urinary tract infection and regulate the patient’s status. Surgical treatment is usually performed by lumbar drilling, also known as percutaneous nephrolithotomy. When choosing lumbar drilling surgery, the choice of location is important. A good location helps to improve the efficiency of stone extraction, reduce damage and lower the risk of surgery. It is important to remove as many stones as possible during surgery for cast stones caused by infection. Residual stones contain bacteria, which can cause stones to recur quickly and re-form cast stones.